Abstract

Background: Laparoscopic Roux en Y gastric bypass (LRYGB) is a hybrid procedure that combines gastric restriction with gastrectomy and malabsorption, whereas laparoscopic sleeve gastrectomy (LSG) is a restrictive method often used initially for patients with severe obesity.

Methods: This prospective randomized controlled trial involved 80 patients between 18 to 65 years . The study included patients with a body mass index (BMI) of ≥40 kg/m2, with or without medical comorbidities, and those with a ≥BMI of 35 kg/m2 accompanied by obesity-related comorbidities. The participants were randomly assigned into two groups: Group I, consisting of 40 patients who underwent Laparoscopic Sleeve Gastrectomy (LSG), and Group II, comprising 40 patients who received Laparoscopic Roux en Y Gastric Bypass (LRYGB).

Results: The percentages of total and excess weight loss after 3, 6 months, and 1 year showed no significant differences between the two groups. Improvements in hypertension, type II diabetes, and dyslipidemia were more pronounced in the group II than group I. Regarding nutritional status; serum iron, ferritin A, and calcium levels were significantly lower at 3, 6 months, and 1 year in group II compared to group I (P value < 0.05).

Conclusions: Sleeve gastrectomy and gastric bypass are equally effective in terms of excess weight loss and total body weight loss after one year. While LSG shows more favorable results in preserving nutritional status one-year post-surgery, LRYGB is more effective in resolving comorbidities like hyperlipidemia, diabetes mellitus, and hypertension.