The two most common obesity surgeries, gastric bypass and gastric sleeve, have few short-term complications and show no significant differences, according to study findings published in the journal JAMA Network Open. These are the first results of a multicentre randomised controlled trial comparing obesity surgeries conducted by the University of Gothenburg.
Patients undergoing obesity surgery will normally have a BMI of at least 40, or 35 if they also have other serious medical conditions related to obesity.
The most common procedures are gastric bypass, where a large part of the stomach and part of the small intestine are bypassed, and gastric sleeve, where a large part of the stomach is surgically removed.
The aim of the current study was to compare the short-term risks of the different procedures.
The study is the largest of its kind. 1735 adult patients planned for surgery in Norway and Sweden between 2015 and 2022 agreed to participate, and they were randomly assigned to either gastric bypass or gastric sleeve.
Relatively few complications
Surgical time was longer for gastric bypass, averaging 68 minutes compared to 47 minutes for gastric sleeve, but hospitalisation after surgery was one day regardless of method.
The follow-ups also gave equivalent results for the two methods.
At 30 days after surgery, both groups had relatively few complications such as haemorrhage, leakage, blood clots and infections.
No deaths occurred during the follow-up period of a total of 90 days.
“For both surgical procedures, the risk of complications is very low, especially from an international perspective, and there is no statistically significant or clinically relevant difference between the groups,” says Suzanne Hedberg, first author of the study.
Many stakeholders and many opinions
“Many people have had surgery, or are on waiting lists for surgery, and there are lots of discussions and opinions about the different methods. What the study shows is that patients and doctors can now choose their surgical method without considering short-term surgical risks,” she says.
Suzanne Hedberg defended her thesis in surgery at Sahlgrenska Academy, University of Gothenburg in April 2023, and is a consultant at Sahlgrenska University Hospital.
The study, included in her thesis, is the first publication with results from BEST (Bypass Equipoise Sleeve Trial), a Scandinavian registry-based randomised controlled multicentre study comparing the two methods of obesity surgery.
The main outcome of the trial which analyses the risk of complications and weight progression over 5 years, is expected to be completed in 2028.
“For the ongoing studies, we are off to a good start with equivalent groups, laying a good foundation for further comparisons of more long-term results,” concludes Suzanne Hedberg.
Source: University of Gothenburg
