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Background <p>Metabolic bariatric surgery (MBS) such as the Roux-en-Y gastric bypass (RYGB) is effective in the treatment of obesity. However, not every patient achieves optimal clinical response and recurrent weight gain remains a concern. Hypothetically, a narrow longer pouch could lead to better results by preventing pouch dilatation and slowing down gastric emptying rates. The aim of this study is to evaluate the effect of an extended pouch gastric bypass (EP-RYGB) on weight loss and quality of life 5 to9years (median 109 months [104–116]) postoperatively.</p> Methods <p>Follow-up study of a single-blinded RCT including 62 patients who underwent a standard Roux-en-Y gastric bypass (S-RYGB, <i>n</i> = 30) versus EP-RYGB (<i>n</i> = 32) between September 2014 and October 2015. Outcomes on weight loss, obesity related complications, health-related quality of life (HRQoL), and gastro-intestinal symptomswere compared between S-RYGB and EP-RYGB.</p> Results <p>Mean total weight loss (%TWL) was higher in EP-RYGB compared to S-RYGB (26.1 ± 11.2%, versus 24.1 ± 10.1%) although not statistically significant. More patients in the S-RYGB group tended to experience recurrent weight gain compared to EP-RYGB (70% versus 47%, <i>p</i> = 0.07). HRQoL and gastro-intestinal symptoms were comparable between groups (<i>p</i> &gt; 0.05 for all).</p> Conclusion <p>EP-RYGB results in slightly better weight loss outcomes and similar HrQoL compared to S-RYGB 5 to 9 years postoperatively. However, due to loss to follow up, the current study is underpowered and a definitive long term advantage of EP-RYGB cannot be concluded.</p>

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Extended Versus Standard Pouch in Roux-en-Y Gastric Bypass: Five To Nine Year Follow-Up Results of a Randomized Controlled Trial

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  • 发表日期：

    2026年2月13日

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  • Mitchell J. R. Harker,
  • Sietske Okkema,
  • Maud Schuurman,
  • Laura Heusschen,
  • Guusje Vugts,
  • Eric J. Hazebroek

摘要

Background

Metabolic bariatric surgery (MBS) such as the Roux-en-Y gastric bypass (RYGB) is effective in the treatment of obesity. However, not every patient achieves optimal clinical response and recurrent weight gain remains a concern. Hypothetically, a narrow longer pouch could lead to better results by preventing pouch dilatation and slowing down gastric emptying rates. The aim of this study is to evaluate the effect of an extended pouch gastric bypass (EP-RYGB) on weight loss and quality of life 5 to9years (median 109 months [104–116]) postoperatively.

Methods

Follow-up study of a single-blinded RCT including 62 patients who underwent a standard Roux-en-Y gastric bypass (S-RYGB, n = 30) versus EP-RYGB (n = 32) between September 2014 and October 2015. Outcomes on weight loss, obesity related complications, health-related quality of life (HRQoL), and gastro-intestinal symptomswere compared between S-RYGB and EP-RYGB.

Results

Mean total weight loss (%TWL) was higher in EP-RYGB compared to S-RYGB (26.1 ± 11.2%, versus 24.1 ± 10.1%) although not statistically significant. More patients in the S-RYGB group tended to experience recurrent weight gain compared to EP-RYGB (70% versus 47%, p = 0.07). HRQoL and gastro-intestinal symptoms were comparable between groups (p > 0.05 for all).

Conclusion

EP-RYGB results in slightly better weight loss outcomes and similar HrQoL compared to S-RYGB 5 to 9 years postoperatively. However, due to loss to follow up, the current study is underpowered and a definitive long term advantage of EP-RYGB cannot be concluded.