Background

Sleeve gastrectomy and Roux-en-Y gastric bypass (RYGB) are the two most common bariatric procedures. we aimed to examine how key selective factors, including BMI, GERD, diabetes, ASA class, and comorbid conditions are represented in patients undergoing each bariatric procedure.

Methods

The MBSAQIP public use file was queried to identify patients who underwent primary RYGB and sleeve gastrectomy in 2018. Pre-operative variables were assessed with Chi squared test using JMP version 15.0 (SAS Institute Inc, Cary, NC, USA).

Results

We identified 127,631 patients who underwent primary sleeve gastrectomy and 48,735 who underwent primary RYGB. Within each group (sleeve, RYGB) the mean HA1c (6.4, 6.5) and smoking status (8.4% vs 7.9% active smokers) was similar, while the BMI was significantly higher (44.9 vs. 45.8, p<0.01) in RYGB patients. RYGB patients had a higher incidence of GERD (41.5% vs 26.6%, p<0.01). Similarly, there was a higher incidence of insulin dependent diabetes (13.4vs6.5%, p<0.01), obstructive sleep apnea (OSA) (44.6vs 36.3%), pre-operative hypertension (52.5% vs 45.5%, p<0.01) and hyperlipidemia (HLD) (28.5% vs 21.4%, p<0.01) in RYGB patients. RYGB patients had a larger proportion of ASA class 3 (79.8 vs 74.0%, p<0.01).

Conclusions

Patients who underwent RYGB were more likely to have significant co-morbidities such as GERD, hypertension, HLD, and OSA. Rates of active smoking were similar between groups despite the increased risk in RYGB patients, and bypass patients showed increased rates of higher ASA class. A significant cohort of sleeve gastrectomy patients had preexisting GERD, though lower than the rate in RYGB patients.