Background

Obesity is associated with significant health concerns including major adverse cardiovascular events (MACE). There is ongoing debate regarding long-term weight loss following different metabolic and bariatric surgery (MBS) procedures and impact on MACE. This study evaluated short, mid, and long-term weight loss after Roux-en-Y Gastric Bypass (RYGB) or Sleeve Gastrectomy (SG) and MACE.

Methods

Retrospective review of our institutional MBSAQIP registry (2010-2021) after RYGB or SG was performed. We captured demographics and compared 1-, 5-, and 10-year post-operative weight change and 30-day postoperative complications as defined in the MBSAQIP registry.

Results

Overall, 6,305 patients were included (2,878 SG, 3,427 RYGB). Significant differences (p<0.0001) in preoperative BMI (45.6% versus 44.3%), diabetes (28.5% versus 21.5%) and GERD (29.7% versus 24.4%) were detected in RYGB versus SG, and RYGB patients had increased procedure lengths and lengths of stay . No differences in VTE, MI, ICU admission, 30-day intervention or 30-day mortality were observed between RYGB and SG patients. Higher incidences of reoperation (7.5% versus 4.6%; p<0.0001) and readmission (4.8% versus 3.4%; p<0.05) occurred in RYGB vs SG. Percent excess weight loss (%EWL) was significantly higher at 1, 5, and 10-years for RYGB (48.7%) versus SG (38.1%) patients. There were no differences in MACE or all-cause mortality in RYGB vs SG.

Conclusions

Despite expected differences in co-morbidities between RYGB and SG patients we observed increased weight loss in RYGB patients with similar MACE profiles and observed persistent %EWL at 10-years for RYGB vs SG.