The bariatric surgery and weight losing: a meta-analysis in the long- and very long-term effects of laparoscopic adjustable gastric banding, laparoscopic Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy on weight loss in adults

Background Several studies have been investigated to find the long-term effect of bariatric surgery on weight loss; nevertheless, a meta-analysis can detailedly demonstrate the effect of bariatric surgery on weight in morbidly obese patients. This study aimed to assess the long-and very long-term effects of laparoscopic adjustable gastric banding (LAGB), laparoscopic Roux-en-Y gastric bypass (LRYGB), and laparoscopic sleeve gastrectomy (LSG) on weight loss in adults. Methods An electronic search using PubMed, Scopus, and Google scholar databases was performed for all English- language articles up to May 15, 2016 with no publication date restriction. Outcome was long-term (>= 5-10 years) and very long-term (>= 10 years) weight reduction that reported as the mean % EWL and changes in BMI from baseline. Results Eighty articles with 87 arms were included in this meta-analysis. The excess weight loss percentage (% EWL) was 47.94% and 47.43% after LAGB at >= 5 and >= 10 years, respectively. After LRYGB the % EWL was 62.58% at >= 5 years and 63.52% at = 10 years. It was 53.25% at >= 5 years after LSG. Results of subgroup analyses have indicated that LRYGB leads to higher % EWL in America and Asia compared with Europe. Meta-regression analyses have shown that there is no significant association between % EWL and baseline age, BMI and length of follow-up after three procedures. However, there is a positive association between gender and % EWL after LRYGB (beta= 1.24). No publication bias was found. Conclusions These findings suggest that LRYGB is an effective procedure in morbidly obese patients that leads to sustainable weight loss over the long-and very long-term periods in compared with LAGB and LSG.