| Abstract [eng] |
Purpose: Roux-en-Y Gastric Bypass (RYGB) is the second most commonly performed bariatric surgery and has demonstrated significant postoperative weight loss and improvement in obesity-related comorbidities. However, long-term results of 10 years or more are insufficiently documented. This systematic review aims to analyze the outcomes of studies and provide an up-to-date perspective on the successes and challenges of RYGB. Methods: The comprehensive literature review followed the 2020 PRISMA guidelines using PubMed, Cochrane Controlled Trials Register, and ScienceDirect databases. It includes publications from the years 2014- 2024. The research was conducted from January 2024 to May 2024 and included only articles with full texts available in English. Results: Of the initial 313 articles, 257 were excluded for not fulfilling the predetermined inclusion criteria. 40 full-text articles were assessed for eligibility, with 29 articles meeting the inclusion criteria. In the included studies, 11,435 patients underwent RYGB as the primary surgery procedure; therefrom, 4,995 patients (44%) completed the 10-year follow-up. After ten years, the BMI decreased to 35.9 (±4.1) kg/m² from an initial average of 49.1 (±3.4) kg/m². The % TWL, %EWL, and %EBMIL results were 28.9 (±3.8)%, 60.9 (±7.6)%, and 57.8 (±9.8)%, respectively, ten years post-RYGB. Comparing the 2-year and 10-year results, a decrease in % TWL, %EWL, and %EBMIL values by -6.75%, -14.23%, and -18.19% was revealed, along with an increase in the BMI of 19.04%, indicating a gradual reduction in weight loss in the long term. These differences in weight loss values between the 2-year and 10-year time mark were statistically significant. A remission of type 2 diabetes was noted in 61.9% of patients 10 years post-RYGB. Arterial hypertension, dyslipidemia, obstructive sleep apnea, and gastroesophageal reflux disease displayed remission rates of 49.5%, 61.3%, 66.1%, and 54.4%, respectively. Conclusion: This systematic review confirms the highly effective outcomes of RYGB surgery, including the success in reducing specific weight loss values and improving the remission rates of obesity-related comorbidities. However, low follow-up rates and the lack of unity in the definition of RYGB success make it challenging for the reviewer to evaluate the overall effectiveness. |
