Is the Sleeve Gastrectomy Always a Better Procedure? Five-Year Results from a Retrospective Matched Case-Control Study

Introduction: Bariatric surgery is considered the most effective treatment for obesity. A recent worldwide survey demonstrated that Laparoscopic Sleeve Gastrectomy (LSG) is the most commonly performed bariatric procedure, while Laparoscopic Adjustable Gastric Banding (LAGB) has been almost abandoned. Objectives: The aim of this retrospective study was to compare 5-year results of LSG and LAGB at our Institution. Materials and Methods: Prospective maintained database of our Institution was reviewed to find all patients who had undergone LSG between January 2009 and December 2011. Inclusion criteria were BMI of 40–50 kg/m2and age of 18–60 years old. Patients with Class I and II obesity, superobese subjects, and patients with previous history of bariatric surgery were excluded. Data on sex, age, pre-operative BMI, obesity-related diseases (diabetes, hypertension, dyslipidemia), and early and late complications were collected. Each subject who underwent LSG was matched one-to-one with a patient that had undergone LAGB. Outcomes were analyzed at 1, 3, and 5 years of follow-up. Results: A total number of 122 patients were included in this study, 61 in each group. Better %EWL was observed in the LSG group at 1, 3, and 5 years. Both procedures induced improvements of obesity-related diseases without significant difference. In the LAGB group, ten patients underwent uneventful band removal. In the LSG group, two patients had serious postoperative complications. Conclusion: LSG achieves better %EWL than LAGB within 5 years, but comorbidities improvement is not significantly different. Severity of complication is higher after LSG. LAGB is still a good option for selected patients.