الفهرس 
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Abstract
BACKGROUND: Obesity is a growing medical and socioeconomic problem. Morbid obesity was defined as a body mass index exceeding 40 or a body mass index of 35 or greater with significant coexisting disease that could be improved by weight loss. Health consequences attributed to obesity are well documented and involve physical, psychological, and social consequences. After bariatric surgery, patients have been shown to have an improvement or a complete resolution of their co- morbidities. Laparoscopic sleeve gastrectomy (LSG) has been gaining acceptance because it has shown good short- and mid-term results as a single procedure for morbid obesity.
Objectives: Our objective in this study is to compare short- and mid-term results between Laparoscopic Sleeve Gastrectomy (LSG) and laparoscopic Roux-en-Y gastric bypass (LRYGB) as a surgical modalities in management o morbid obesity regarding post operative leakage and weight loss in Ain Shams University Hospitals.
Patients and methods: This study is a retrospective comparative study that was conducted in Ain Shams University Hospitals in Egypt, and included sixty (60) patients who had morbid obesity. The patients were divided into two groups. In the first group (group A) 35 patients did laparoscopic Sleeve Gastrectomy (LSG) and in the other group (group B) 25 patients did laparoscopic Roux-en-Y gastric bypass (LRYGB). The study was conducted from December, 2014 to December, 2015, with 12 months of follow-up post-operatively. Subjects were matched primarily based on age, gender, pre-operative weight and BMI, and secondarily on Short- and mid-term weight loss, postoperative complications and re-interventions. Statistical analysis was performed using Chi-square test and Fisher exact test for comparison between two groups regarding qualitative data, using Independent t-test for comparison between two independent groups with quantitative data and parametric distribution, using Repeated Measures ANOVA followed by post hoc analysis using Bonferoni test for comparison between more than two paired groups regarding quantitative data with parametric distribution.
RESULTS: The mean age of the patients was 33.75 ± 10.17 (16-58) and the mean BMI was 47.54 ± 6.23 (36-66). There was no statistically significant difference found between LSG group and RGBP group regarding demographic data and anthropometric measures of the studied cases at presentation. There was no statistically significant difference found between LSG group and RGBP group regarding comorbidites except DM and osteoarthritis showed higher incidence in selected RGBP group than LSG group with p-value = 0.010 and 0.001 respectively. There was increase in the incidence of leakage and second look in LRYGB group than LSG group but with no statistically significant difference between them with p-value = 0.089 and 0.089 respectively. there was no statistically significant difference found between LSG group and LRYGB group regarding excess weight loss at 1 month, 3 months and 6 months follow up with p-value = 0.731, 0.939 and 0.712 respectively.
CONCLUSIONS: Both LRYGB and LSG are safe procedures that provide good results in weight loss. There is a similar short- and mid-term weight loss between LRYGB and LSG, although complications like leakage incidence rate is higher for LRYGB. Results of LSG as a single procedure need to be confirmed after a long-term follow-up.