Efectividad comparativa de la gastrectomía versus bypass gástrico en adultos con obesidad: revisión sistemática.

Abstract

Introduction: Obesity is a major public health problem and is associated with multiple comorbidities. In obese adults requiring surgical treatment, vertical sleeve gastrectomy and Roux-en-Y gastric bypass are among the most commonly used bariatric procedures; however, differences persist in weight loss, metabolic outcomes, and complication profiles. This study aimed to compare the effectiveness of both procedures in adults with obesity through a systematic review of the scientific literature. To this end, a systematic review was conducted in accordance with the PRISMA 2020 guidelines, using searches in Scopus, PubMed, and Web of Science. Studies published within the established eligibility period that evaluated clinical outcomes for both procedures, including changes in body mass index (BMI), metabolic control, and complications, were included. Fifteen studies were included in the synthesis. The results showed that both procedures were associated with a significant reduction in BMI. Gastric bypass showed a trend toward greater weight loss and improvement in some metabolic comorbidities, while vertical sleeve gastrectomy presented a favorable profile for certain safety and tolerability outcomes. However, heterogeneity was identified among the studies analyzed. It was concluded that both procedures are effective alternatives for the surgical treatment of adults with obesity. Although gastric bypass offers advantages in certain weight and metabolic outcomes, the choice of procedure should be individualized, considering clinical characteristics, risks, patient preferences, and the team’s experience. Keywords: vertical sleeve gastrectomy, Roux-en-Y gastric bypass, obesity, bariatric surgery, adults