{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,9]],"date-time":"2026-11-09T09:59:04Z","timestamp":1794218344363,"version":"4.8.0"},"reference-count":34,"publisher":"American Medical Association (AMA)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Surg"],"published-print":{"date-parts":[[2025,4,1]]},"abstract":"\n Importance<\/jats:title>\n Reports on long-term outcomes from randomized clinical trials comparing laparoscopic sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) are scarce.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To compare long-term weight and metabolic outcomes, reoperation rates, and quality of life for patients undergoing SG vs RYGB at 10 years and beyond.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n The SM-BOSS (Swiss Multicenter Bypass or Sleeve Study) randomized clinical trial was conducted from January 2007 to November 2011 at 4 bariatric centers in Switzerland. (The last follow-up was obtained in July 2023.) A total of 3971 patients with severe obesity were assessed, and 217 patients were enrolled and randomized to undergo SG or RYGB.<\/jats:p>\n <\/jats:sec>\n \n Interventions<\/jats:title>\n Laparoscopic SG or RYGB.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n The primary outcome of the SM-BOSS trial was the percentage excess body mass index loss (%EBMIL) at 5 years. The present study reports on the long-term weight and metabolic outcomes at 10 years and beyond, including changes in weight and obesity-related diseases, reoperation rates, and quality of life.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Of 217 patients randomized to undergo SG or RYGB, mean (SD) age was 42.5 (11.1) years, mean (SD) baseline BMI was 43.9 (5.3), and 156 patients (71.9%) were female. Of 217 patients, 110 patients were randomized to RYGB and 107 to SG. Complete 10-year follow-up is available for 65.4% of patients. In the intention-to-treat population, mean (SD) %EBMIL was 60.6% (25.9) after SG and 65.2% (26.0) after RYGB (\n P<\/jats:italic>\n \u2009=\u2009.29). Patients who underwent SG had significantly higher conversion rates because of insufficient weight reduction or reflux compared to RYGB (29.9% vs 5.5%;\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001). Patients undergoing RYGB had significantly higher mean (SD) %EBMIL compared to SG after 10 years in the per-protocol (PP) population (65.9% [26.3] vs 56.1% [25.2];\n P<\/jats:italic>\n \u2009=\u2009.048). However, mean (SD) percentage total weight loss was not significantly different between groups (RYGB: 27.7% [10.8]; SG: 25.5% [15.1];\n P<\/jats:italic>\n \u2009=\u2009.37). SG patients had significantly more de novo gastroesophageal reflux (GERD) compared with RYGB (\n P<\/jats:italic>\n \u2009=\u2009.02).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n In the SM-BOSS randomized clinical trial, RYGB led to significantly higher %EBMIL in the PP population compared with SG beyond 10 years of follow-up, with better results for GERD. Patients undergoing SG experienced a significantly higher number of conversions to different anatomy compared with RYGB.<\/jats:p>\n <\/jats:sec>\n \n Trial Registration<\/jats:title>\n \n ClinicalTrials.gov Identifier\n NCT00356213<\/jats:ext-link>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamasurg.2024.7052","type":"journal-article","created":{"date-parts":[[2025,2,19]],"date-time":"2025-02-19T11:00:44Z","timestamp":1739962844000},"page":"369","source":"Crossref","is-referenced-by-count":85,"title":["Long-Term Outcomes of Laparoscopic Roux-en-Y Gastric Bypass vs Laparoscopic Sleeve Gastrectomy for Obesity"],"prefix":"10.1001","volume":"160","author":[{"given":"Marko","family":"Kraljevi\u0107","sequence":"first","affiliation":[{"name":"Clarunis, Department of Visceral Surgery, University Digestive Health Care Center, St Clara Hospital and University Hospital, Basel, 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Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Bueter","sequence":"additional","affiliation":[{"name":"Department of Visceral Surgery and Transplantation, University Hospital Zurich, Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Gero","sequence":"additional","affiliation":[{"name":"Department of Visceral Surgery and Transplantation, University Hospital Zurich, Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernd","family":"Schultes","sequence":"additional","affiliation":[{"name":"Metabolic Center St Gallen, friendlyDocs, St Gallen, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adisa","family":"Poljo","sequence":"additional","affiliation":[{"name":"Clarunis, Department of Visceral Surgery, University Digestive Health Care Center, St Clara Hospital and University Hospital, Basel, 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