Laparoscopic sleeve gastrectomy: More than a restrictive bariatric surgery procedure?

Table 4 Clinical outcomes of sleeve gastrectomy and Roux-en-Y gastric bypass

	SG	RYGB
Weight loss	No differences with RYGB	No differences with SG
	67.1 %EWL at 12 mo[63]	68.9% EWL at 12 mo[63]
Type 2 diabetes mellitus remission	Early improvement before significant weight loss	Slightly more effective than SG. HR 1.49, 95%CI: 1.04-2.12 for type 2 diabetes mellitus remission in favor of RYGB[63]
	More effective than other restrictive techniques
Hypertension remission	Greater efficacy than other restrictive techniques	More effective than SG
	69% (55-82) Hypertension remission for SG and 45% (27-56) for LAGB[72]	HR of 1.47, 95%CI: 1.115-1.86 for Hypertension remission in favor of RYGB[63]
Dyslipidemia remission	Same as other malabsorptive techniques, no hypercholesterolemia improvement	Clearly more effective than SG. HR = 2.41, 95%CI: 1.87-3.11 for Dyslipidemia remission in favor of RYGB[63]
Mortality	No differences (detailed in table 2)	No differences
Surgical complications	Less surgical time, lowest 30-d morbidity, 30-d readmission and 30-d reoperation. (detailed in table 2)	Increased risk of nutritional deficiencies
	Characteristic complications: staple line leaks (2.7%[86]; < 1% in expert hands[87])	Characteristic complications: severe hypoglycemia
Long-term results	Limited evidence	Effective and safe in the long term
Other advantages	Possibility of conversion to a malabsorptive surgery

SG: Sleeve gastrectomy; RYGB: Roux-en-Y gastric bypass; %EWL: Percentage excess weight loss; HR: Hazard ratio; LABG: Laparoscopic adjustable gastric banding.