Sleeve gastrectomy tied to lower health care utilization, but five-year death, complications, reoperation, revision similar to gastric bypass
By Lori Solomon HealthDay Reporter
FRIDAY, Dec. 2, 2022 (HealthDay News) — Among U.S. adolescents with severe obesity, sleeve gastrectomy is significantly associated with lower rates of health care utilization but similar rates of death, complications, reoperation, and revision versus gastric bypass, according to a research letter published in the Nov. 15 issue of the Journal of the American Medical Association.
Ryan Howard, M.D., from the University of Michigan in Ann Arbor, and colleagues used national Medicaid claims to identify adolescents (aged 19 years and younger) with severe obesity who underwent either laparoscopic sleeve gastrectomy (855 patients) or Roux-en-Y gastric bypass (277 patients; 2012 through 2018). Five-year outcomes were compared by bariatric surgery type.
The researchers found that sleeve gastrectomy was associated with a significantly lower five-year risk for emergency department use compared with gastric bypass (53.3 versus 59.9 percent) and hospitalization (36.9 versus 52.1 percent). However, there were no significant differences in rates of complications (1.5 versus 2.1 percent) or reoperation (7.2 versus 7.7 percent). Sleeve gastrectomy and gastric bypass were also found to be similar in regards to rates of death (0.2 versus 0 percent) or revision (1.1 versus 0.7 percent).
“These results may help inform the treatment of severe obesity in adolescents insured by Medicaid, although future studies should also evaluate long-term weight loss and comorbidity resolution in this population,” the authors write.
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