Therapeutic Effect Of Roux-en-Y Gastric Bypass And Sleeve Gastrectomy For Obesity:A Meta-analysis

Objective:To investigate the efficacy of two popular metabolic surgery sleeve gastrectomy(SG)and Roux-en-Y gastric bypass(RYGB)in treating obesity patients and the effect of treating obesity-related complications.Methods:Six datebases,Pubmed,EMBASE,Cochrane Library,CNKI,Wanfang,and Weipu were retrieved by computer.Related literature has been collected about the therapeutic effects of SG and RYGB in the treatment of obesity.The collection time is set to establish the database until July 31,2019.Meta-analysis was performed using RevMan 5.3software for compliance data.Cochrane risk assessment tools were used to evaluate the quality of the included literature.The GRADE evidence quality grading system was used to evaluate the evidence quality of the outcome indicators.Results:Ultimately,the study selected 12 papers.A total of 1465 cases were included,including 736 in the sleeve gastrectomy(SG)group and 729 in the Roux-en-Y gastric bypass(RYGB)group.Meta-analysis showed that the RYGB group had a lower BMI(MD=1.34,95% CI=0.35 ~ 2.34,P<0.05)and a higher remission rate of dyslipidemia(OR=2.74,95% CI=1.74~4.32,P<0.05)than the SG group.There was no significant difference in the percentage of excess body weight loss,HbA1 c,hypertension remission rate and type 2 diabetes mellites remission rate between the two groups(MD=4.72,95% CI=-1.50~10.94,P>0.05;MD=0.05,95% CI=-0.30~0.41,P>0.05;OR=1.32,95% CI=0.86~2.02,P>0.05;OR=1.46,95% CI=0.79~2.69,P>0.05).The results of GRADE systematic review of evidence quality showed that the quality of evidence of BMI and HbA1 c changes was moderate.The quality of the% EWL indicator evidence is low quality.The quality of evidence for hypertension response rate indicators,dyslipidemia response rate indicators,and type 2 diabetes response rate indicators is of high quality.Conclusion:Compared with sleeve gastrectomy(SG),Roux-en-Y gastric bypass(RYGB)reduces BMI more and is suitable for more obese patients.Roux-en-Y gastric bypass is better for obese patients with significant dyslipidemia.