Complication and death rates were similar for both gastric bypass and sleeve gastrectomy, according to a study by researchers from University of Michigan Health, who compared the two procedures in adolescents covered by Medicaid. The paper, ‘Health Care Use and Adverse Events After Sleeve Gastrectomy and Gastric Bypass Among Adolescents With Severe Obesity Insured by Medicaid’, was published in JAMA.
Although Medicaid is the single largest insurer of adolescents in the US, the comparative outcomes (which may help inform coverage policy and decision-making) of these two procedures have yet to be described in this population.
Therefore, the study authors evaluated comparative health care use and adverse events up to five years after bariatric surgery in adolescents insured by Medicaid.
“Prior research had found that sleeve gastrectomy and gastric bypass resulted in significant weight loss and low complication rates in adolescents with severe obesity,” said Dr Ryan Howard, a general surgery resident at University of Michigan Health. “But the comparative outcomes of these two procedures, which might help inform health insurance policy and decision-making, had yet to be explored for adolescents insured by Medicaid.”
The researchers identified just over 1,110 patients who had undergone one of the two weight-loss surgeries between 2012 and 2018, a relatively small number compared to the more than 95,000 patients covered by Medicare who had either gastric bypass or a sleeve gastrectomy in the same time period. All the patients studied had Medicaid, the largest health insurance provider for those under the age of 19 in the United States.
Howard explained that the disparity could be due to access issues or concerns about bariatric surgery as a weight-loss treatment for youth.
Overall, they found that adolescents who underwent sleeve gastrectomy were less likely to go the emergency room or be admitted to the hospital in the five years after their operations, compared with those who had gastric bypass surgery.