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Background <p>Obesity impacts physical, physiological and psychological domains of life. The long-term effects of metabolic bariatric surgery (MBS) on patient-centred outcomes such as mental health and quality of life (QOL) may enhance the management of obesity and the application of MBS.</p> Methods <p>A prospective, blinded, double arm, parallel, randomised trial was carried out at a single bariatric centre in Waitemata, New Zealand. Adults with type 2 diabetes mellitus and obesity were randomised 1:1 to undergo laparoscopic sleeve gastrectomy (SG) or silastic ring Roux-en-Y gastric bypass (SR-RYGB). After unblinding at 5 years, patients were followed up at 10 years. This analysis focuses on secondary outcomes: Hospital Anxiety and Depression Scale (HADS) scores and RAND-36 QOL scores.</p> Results <p>Of 114 patients randomised, 80 patients (70.2%) completed 10-year follow up (39 SG; 41 SR-RYGB). SR-RYGB was associated with greater weight loss (33.3&#xa0;kg vs. 25.8&#xa0;kg, <i>p</i> = 0.031) and trended towards higher diabetes remission (31.7% vs. 23.1%, adjusted OR 2.07, 95% CI 0.70, 6,10, <i>p</i> = 0.186). Mean HADS anxiety score for SG decreased by 1.59 units over 10-years (<i>p</i> = 0.027). Improvements in RAND-36 scores were significantly greater after 10 years for SR-RYGB than SG for physical function (19 vs. 12 points, <i>p</i> = 0.026) and general health (17 vs. 10 points, <i>p</i> = 0.036). Role limitation due to emotional problems worsened significantly by 16 points for the SG group (<i>p</i> = 0.032).</p> Conclusion <p>SR-RYGB demonstrated superior long-term improvements in physical function and general health QOL domains of RAND-36 compared to SG. Anxiety symptoms may be reduced long-term following SG. </p>

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Sleeve Gastrectomy Versus Banded Roux-en-Y Gastric Bypass for Obesity and Diabetes Mellitus: Psychology and Quality of Life Outcomes at 10 Years

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年4月8日

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  • Preekesh Suresh Patel,
  • Megan Grinlinton,
  • Anamitra Nair,
  • Jack Pullman,
  • Lindsay D Plank,
  • Rinki Murphy,
  • Michael Booth

摘要

Background

Obesity impacts physical, physiological and psychological domains of life. The long-term effects of metabolic bariatric surgery (MBS) on patient-centred outcomes such as mental health and quality of life (QOL) may enhance the management of obesity and the application of MBS.

Methods

A prospective, blinded, double arm, parallel, randomised trial was carried out at a single bariatric centre in Waitemata, New Zealand. Adults with type 2 diabetes mellitus and obesity were randomised 1:1 to undergo laparoscopic sleeve gastrectomy (SG) or silastic ring Roux-en-Y gastric bypass (SR-RYGB). After unblinding at 5 years, patients were followed up at 10 years. This analysis focuses on secondary outcomes: Hospital Anxiety and Depression Scale (HADS) scores and RAND-36 QOL scores.

Results

Of 114 patients randomised, 80 patients (70.2%) completed 10-year follow up (39 SG; 41 SR-RYGB). SR-RYGB was associated with greater weight loss (33.3 kg vs. 25.8 kg, p = 0.031) and trended towards higher diabetes remission (31.7% vs. 23.1%, adjusted OR 2.07, 95% CI 0.70, 6,10, p = 0.186). Mean HADS anxiety score for SG decreased by 1.59 units over 10-years (p = 0.027). Improvements in RAND-36 scores were significantly greater after 10 years for SR-RYGB than SG for physical function (19 vs. 12 points, p = 0.026) and general health (17 vs. 10 points, p = 0.036). Role limitation due to emotional problems worsened significantly by 16 points for the SG group (p = 0.032).

Conclusion

SR-RYGB demonstrated superior long-term improvements in physical function and general health QOL domains of RAND-36 compared to SG. Anxiety symptoms may be reduced long-term following SG.