***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Importance Sleeve gastrectomy is increasingly used in the treatment of morbid obesity , but its long-term outcome vs the st and ard Roux-en-Y gastric bypass procedure is unknown . Objective To determine whether there are differences between sleeve gastrectomy and Roux-en-Y gastric bypass in terms of weight loss , changes in comorbidities , increase in quality of life , and adverse events . Design , Setting , and Participants The Swiss Multicenter Bypass or Sleeve Study ( SM-BOSS ) , a 2-group r and omized trial , was conducted from January 2007 until November 2011 ( last follow-up in March 2017 ) . Of 3971 morbidly obese patients evaluated for bariatric surgery at 4 Swiss bariatric centers , 217 patients were enrolled and r and omly assigned to sleeve gastrectomy or Roux-en-Y gastric bypass with a 5-year follow-up period . Interventions Patients were r and omly assigned to undergo laparoscopic sleeve gastrectomy ( n = 107 ) or laparoscopic Roux-en-Y gastric bypass ( n = 110 ) . Main Outcomes and Measures The primary end point was weight loss , expressed as percentage excess body mass index ( BMI ) loss . Exploratory end points were changes in comorbidities and adverse events . Results Among the 217 patients ( mean age , 45.5 years ; 72 % women ; mean BMI , 43.9 ) 205 ( 94.5 % ) completed the trial . Excess BMI loss was not significantly different at 5 years : for sleeve gastrectomy , 61.1 % , vs Roux-en-Y gastric bypass , 68.3 % ( absolute difference , −7.18 % ; 95 % CI , −14.30 % to −0.06 % ; P = .22 after adjustment for multiple comparisons ) . Gastric reflux remission was observed more frequently after Roux-en-Y gastric bypass ( 60.4 % ) than after sleeve gastrectomy ( 25.0 % ) . Gastric reflux worsened ( more symptoms or increase in therapy ) more often after sleeve gastrectomy ( 31.8 % ) than after Roux-en-Y gastric bypass ( 6.3 % ) . The number of patients with reoperations or interventions was 16/101 ( 15.8 % ) after sleeve gastrectomy and 23/104 ( 22.1 % ) after Roux-en-Y gastric bypass . Conclusions and Relevance Among patients with morbid obesity , there was no significant difference in excess BMI loss between laparoscopic sleeve gastrectomy and laparoscopic Roux-en-Y gastric bypass at 5 years of follow-up after surgery . Trial Registration clinical trials.gov Identifier : Background Laparoscopic Roux-en-Y gastric bypass ( LRYGB ) is currently the gold st and ard bariatric procedure for the treatment of morbid obesity . Laparoscopic sleeve gastrectomy ( LSG ) is a relatively innovative procedure which has been increasingly applied lately as a sole bariatric procedure . A r and omized trial was conducted in a Greek population to evaluate perioperative safety and 3-years results . Methods Sixty patients with body mass index ( BMI ) ≤ 50 Kg/m2 were r and omized to LRYGB or LSG .  Patients were monitored for 3 years postoperatively and throughout the study period weight loss , in terms of percent excess weight loss ( % EWL ) , early and late complications , improvement of obesity related comorbidities and nutritional deficiencies were compared between groups . Results There was no death in either group and there was no significant difference in early ( 10 % after LRYGB and 13 % after LSG , P > 0.05 ) and late morbidity ( 10 % in each group ) . Weight loss was significantly better after LSG in the first years of the study and at 3 years % EWL reached 62 % after LRYGB and 68 % after LSG ( p = 0.13 ) . There was no significant difference in the overall improvement of comorbidities . Nutritional deficiencies occurred at the same rate in the two groups except to vitamin B12 deficiency which was more common after LRYGB ( P = 0.05 ) . Conclusion LSG and LRYGB are equally safe and effective in the amelioration of comorbidities , while LSG is associated with fewer postoperative metabolic deficiencies , without the need of supplementation . Furthermore , LSG is a promising bariatric procedure , equally effective to LRYGB at 3 years follow up on weight reduction Background Obesity is associated with gastroesophageal reflux disease . Roux-en-Y gastric bypass is the most performed bariatric procedure in the world , whereas sleeve gastrectomy is an emerging procedure . Both can be combined with the use of a Silastic ® ring . The aim of this study was to compare the evolution of erosive esophagitis ( EE ) in patients who underwent Silastic ® ring gastric bypass ( SRGB ) and Silastic ® ring sleeve gastrectomy ( SRSG )  after a 1-year postoperative period . Methods We carried out a non-r and omized , prospect i ve , controlled clinical study . Sixty-five patients were enrolled based on the following inclusion criteria : female gender , age 20–60 years old , BMI 40–45 and written informed consent . The exclusion criteria were secondary obesity , alcohol or drug use , severe psychiatric disorder , binge-eating of sweets , and previous stomach or bowel surgery . The patients were divided into two groups—33 ( 51 % ) underwent SRSG and 32 ( 49 % ) patients underwent SRGB . All patients underwent an esophago-gastro-duodenoscopy during the preoperative period and at 12–14 months after the surgery . Results Preoperatively , 15 patients ( 23.8 % ) were found to have EE , six ( 19.4 % ) in the SRSG group and nine patients ( 28.1 % ) in the SRGB group ( p = 0.7795 ) . Postoperatively , there was an increase in the number of patients with EE in the SRSG group to 14 ( 45.2 % ) and a decrease in the SRGB group to two ( 6.3 % ) , giving a total of 16 patients with EE ( 25.4 % ; p = 0.0007 ) . Conclusions After 1 year of follow-up , we observed a worsening evolution of EE in the SRSG group , but improvement in the SRGB group Objective : Laparoscopic sleeve gastrectomy ( LSG ) has been proposed as an effective alternative to the current st and ard procedure , laparoscopic Roux-en-Y gastric bypass ( LRYGB ) . Prospect i ve data comparing both procedures are rare . Therefore , we performed a r and omized clinical trial assessing the effectiveness and safety of these 2 operative techniques . Methods : Two hundred seventeen patients were r and omized at 4 bariatric centers in Switzerl and . One hundred seven patients underwent LSG using a 35-F bougie with suturing of the stapler line , and 110 patients underwent LRYGB with a 150-cm antecolic alimentary and a 50-cm biliopancreatic limb . The mean body mass index of all patients was 44 ± 11.1 kg/m2 , the mean age was 43 ± 5.3 years , and 72 % were female . Results : The 2 groups were similar in terms of body mass index , age , sex , comorbidities , and eating behavior . The mean operative time was less for LSG than for LRYGB ( 87 ± 52.3 minutes vs 108 ± 42.3 minutes ; P = 0.003 ) . The conversion rate was 0.9 % in both groups . Complications ( < 30 days ) occurred more often in LRYGB than in LSG ( 17.2 % vs 8.4 % ; P = 0.067 ) . However , the difference in severe complications did not reach statistical significance ( 4.5 % for LRYGB vs 1 % for LSG ; P = 0.21 ) . Excessive body mass index loss 1 year after the operation was similar between the 2 groups ( 72.3 % ± 22 % for LSG and 76.6 % ± 21 % for LRYGB ; P = 0.2 ) . Except for gastroesophageal reflux disease , which showed a higher resolution rate after LRYGB , the comorbidities and quality of life were significantly improved after both procedures . Conclusions : LSG was associated with shorter operation time and a trend toward fewer complications than with LRYGB . Both procedures were almost equally efficient regarding weight loss , improvement of comorbidities , and quality of life 1 year after surgery . Long-term follow-up data are needed to confirm these facts BACKGROUND Obesity is associated with increased mortality . Weight loss improves cardiovascular risk factors , but no prospect i ve interventional studies have reported whether weight loss decreases overall mortality . In fact , many observational studies suggest that weight reduction is associated with increased mortality . METHODS The prospect i ve , controlled Swedish Obese Subjects study involved 4047 obese subjects . Of these subjects , 2010 underwent bariatric surgery ( surgery group ) and 2037 received conventional treatment ( matched control group ) .  We report on overall mortality during an average of 10.9 years of follow-up . At the time of the analysis ( November 1 , 2005 ) , vital status was known for all but three subjects ( follow-up rate , 99.9 % ) . RESULTS The average weight change in control subjects was less than + /-2 % during the period of up to 15 years during which weights were recorded . Maximum weight losses in the surgical subgroups were observed after 1 to 2 years : gastric bypass , 32 % ; vertical-b and ed gastroplasty , 25 % ; and b and ing , 20 % . After 10 years , the weight losses from baseline were stabilized at 25 % , 16 % , and 14 % , respectively . There were 129 deaths in the control group and 101 deaths in the surgery group . The unadjusted overall hazard ratio was 0.76 in the surgery group ( P=0.04 ) , as compared with the control group , and the hazard ratio adjusted for sex , age , and risk factors was 0.71 ( P=0.01 ) . The most common causes of death were myocardial infa rct ion ( control group , 25 subjects ; surgery group , 13 subjects ) and cancer ( control group , 47 ; surgery group , 29 ) . CONCLUSIONS Bariatric surgery for severe obesity is associated with long-term weight loss and decreased overall mortality Background No r and omized comparative trials have presented long-term outcomes for  laparoscopic sleeve gastrectomy ( LSG ) and laparoscopic Roux-en-Y gastric bypass ( LRYGB ) .  The present study was design ed to compare the efficacy and safety of these two procedures . Methods From January 2007 to July 2008 , 64 eligible patients were r and omly assigned to LSG or LRYGB .  During the 5-year follow-up , we compared morbidity rate , body mass index ( BMI ) , percent of excess weight loss ( % EWL ) , Moorehead-Ardelt ( M-A ) II quality of life , and resolution or improvement rate of obesity-related comorbidities between the groups . Results Both groups were matched with respect to age , gender , and BMI . Slightly more major complications were observed in patients undergoing LRYGB ( P > 0.05 ) . Weight loss was significantly better with LRYGB except during the first postoperative year . At 5 years , % EWL for LSG and LRYGB was 63.2 ± 24.5 % and 76.2 ± 21.7 % ( P = 0.02 ) , respectively . No statistical difference was observed in quality of life between the groups at all intervals ( P > 0.05 ) . At the last follow-up , most comorbidities in both groups were resolved or improved , with no difference between the groups ( P > 0.05 ) . Conclusion LRYGB and LSG are equally safe and effective in quality of life and improvement or resolution of comorbidities , and LRYGB possesses the superiority in terms of weight loss . Further studies are needed to evaluate micronutrient deficiencies of these procedures Background 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 . The aim of this study was to compare short- and mid-term results between laparoscopic Roux-en-Y gastric bypass ( LRYGB ) and LSG . Methods Observational retrospective study from a prospect i ve data base of patients undergoing LRYGB and LSG between 2004 and 2011 , where 249 patients ( mean age 44.7 years ) were included . Patients were followed at 1 , 3 , 6 , 12 , and 18 months , and annually thereafter . Short- and mid-term weight loss , comorbidity improvement or resolution , postoperative complications , re- interventions , and mortality were evaluated . Results One hundred thirty-five LRYGB and 114 LSG were included . Significant statistical differences between LRYGB and LSG were found in operative time ( 153 vs. 93 min . p < 0.001 ) , minor postoperative complications ( 21. 
    Output:
    
There was no significant difference between RYGB and SG in rates of resolution or improvement of diabetes .
Conclusions Both RYGB and SG result in sustained weight loss and comorbidity control at 5 years .
RYGB result ed in greater % EWL , improved dyslipidaemia outcomes and a lower incidence of postoperative gastro-oesophageal reflux disease ( GORD )