Date of Award

2021

Degree Type

Selective Evidence-Based Medicine Review

Degree Name

Master of Science in Health Sciences - Physician Assistant

Department

Physician Assistant Studies

Abstract

OBJECTIVE: The objective of this selective EBM review is to determine whether or not obese patients have a better quality of life after undergoing gastric bypass rather than sleeve gastrectomy.

STUDY DESIGN: A review of 3 randomized controlled trials (RCT) that were published after 2014.

DATA SOURCES: The 3 peer-reviewed randomized controlled trials were found through PubMed. All studies were published in English.

OUTCOMES MEASURED: The outcome measured in these RCTs was overall change in quality of life after sleeve gastrectomy and gastric bypass. This was done by patients responding to questionnaires. Two articles Ignat et al. and Peterli et al. used the Gastrointestinal Quality of Life Index and Murphy et al. used the physical functioning on the SF-36 subscale questionnaire.

RESULTS: The RCT performed by Murphy et al. showed significant positive change from baseline in quality of life one year after surgery for both groups (P<0.001), but no significance between the 2 different surgical interventions (P=0.41). Similarly, Ignat et al. also showed improvement of quality life from baseline one year after surgery (P<0.001) and no significance between the 2 groups (P=0.323). Lastly, Peterli et al. further supported the enhancement in quality of life one year after surgery in both the gastric bypass and sleeve gastrectomy (P=0.003, P=0.001) with no significant difference found between the 2 interventions (P=0.366).

CONCLUSION: The review of these 3 RCTs provides information on the ability of bariatric surgery to improve QoL. Statical significance was noted for change from baseline in all 3 studies with no significance between the 2 intervention groups of sleeve gastrectomy and gastric bypass. Both types of surgery are effective ways to improve quality of life although sleeve gastrectomy is not superior, but comparable, to gastric bypass.

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