Comparing Laparoscopic Sleeve Gastrectomy Versus Laparoscopic Roux-en-Y Gastric Bypass with Hiatal Repair for Severe Obesity and GERD: Short-Term Outcomes
Kandel, M., Wael, M., Elkeleny, M., Altabbaa, H., Madyan, A. (2025). Comparing Laparoscopic Sleeve Gastrectomy Versus Laparoscopic Roux-en-Y Gastric Bypass with Hiatal Repair for Severe Obesity and GERD: Short-Term Outcomes. EKB Journal Management System, (), -. doi: 10.21608/muj.2025.397089.1233
Mohamed Mosaad Kandel; mohamed Wael; mostafa refaie Elkeleny; Hashem Altabbaa; amr Madyan. "Comparing Laparoscopic Sleeve Gastrectomy Versus Laparoscopic Roux-en-Y Gastric Bypass with Hiatal Repair for Severe Obesity and GERD: Short-Term Outcomes". EKB Journal Management System, , , 2025, -. doi: 10.21608/muj.2025.397089.1233
Kandel, M., Wael, M., Elkeleny, M., Altabbaa, H., Madyan, A. (2025). 'Comparing Laparoscopic Sleeve Gastrectomy Versus Laparoscopic Roux-en-Y Gastric Bypass with Hiatal Repair for Severe Obesity and GERD: Short-Term Outcomes', EKB Journal Management System, (), pp. -. doi: 10.21608/muj.2025.397089.1233
Kandel, M., Wael, M., Elkeleny, M., Altabbaa, H., Madyan, A. Comparing Laparoscopic Sleeve Gastrectomy Versus Laparoscopic Roux-en-Y Gastric Bypass with Hiatal Repair for Severe Obesity and GERD: Short-Term Outcomes. EKB Journal Management System, 2025; (): -. doi: 10.21608/muj.2025.397089.1233

Comparing Laparoscopic Sleeve Gastrectomy Versus Laparoscopic Roux-en-Y Gastric Bypass with Hiatal Repair for Severe Obesity and GERD: Short-Term Outcomes

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Articles in Press, Accepted Manuscript, Available Online from 20 August 2025  XML
Document Type: Original Article
DOI: 10.21608/muj.2025.397089.1233
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Authors
Mohamed Mosaad Kandel email orcid 1; mohamed Waelorcid 2; mostafa refaie Elkelenyorcid 3; Hashem Altabbaaorcid 4; amr Madyanorcid 5
1Department of General Surgery- faculty of medicine, port Said university, Egypt
2Faculty Of Medicine, General Surgery department, Alexandria University, Alexandria, Egypt
3Faculty Of Medicine, Department of general surgery, Alexandria University, Alexandria, Egypt
4The Research Papyrus Lab, Alexandria, Egypt
5Faculty Of Medicine,Department of general surgery, Mansoura University, Mansoura, Egypt
Abstract
Background: Laparoscopic Roux-en-Y gastric bypass (LRYGB) and laparoscopic sleeve gastrectomy (LSG) are common bariatric procedures. In patients with obesity and gastroesophageal reflux disease (GERD), simultaneous hiatal hernia repair (HHR) is often indicated. However, the comparative outcomes of LSG+HHR and LRYGB+HHR remain unclear.
Objectives: To compare short-term outcomes of LSG+HHR versus LRYGB+HHR in terms of weight loss, GERD remission, comorbidity resolution, and perioperative parameters.
Methods: Seventy-nine patients with obesity and hiatal hernias were retrospectively analyzed; 37 underwent LSG+HHR and 42 underwent LRYGB+HHR. Primary outcomes were GERD remission, excess weight loss percentage (EWL%), and excess BMI loss percentage (EBMIL%). Secondary outcomes included operative time, hospital stay, comorbidity resolution, and quality of life (QoL) improvement at one year.
Results: LRYGB+HHR achieved significantly greater weight loss at 6 and 12 months (P < 0.001) and higher GERD remission rates (83.8% vs. 61.1%, P < 0.001) with fewer recurrences compared to LSG+HHR. However, LRYGB+HHR had longer operative time (166.74 vs. 68.73 minutes, P < 0.001) and hospital stay (2.24 vs. 1.05 days, P < 0.001). Both procedures effectively improved comorbidities and QoL (P > 0.05).
Conclusions: LRYGB+HHR offers superior outcomes in GERD resolution and weight loss but at the cost of longer operative time and hospitalization. Both procedures effectively improve comorbidities and QoL. Surgical choice should be individualized based on patient characteristics.
Keywords
Gastroesophageal reflux disease; laparoscopic hiatal hernia repair; laparoscopic sleeve gastrectomy; LRYGB
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