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Early- and mid-term results of the SM-BOSS had previously been published in Annals of Surgery in 2013 and 2017 respectively, where it was concluded that sleeve was faster with equal weight loss, complications, quality of life and improvement of co-morbidities than bypass, except for gastroesophageal reflux disease GERD and dyslipidemia.
At the 5-year point, 101 sleeve gastrectomy were compared to 104 gastric bypass. Sleeve patients had less weight loss when compared to the bypass. Differences in diabetes remission, complications, and quality of life were not statistically significant, although GERD and dyslipidemia leaned in favor of the bypass.
In conclusion, bypass seems to better for long-term weight loss and metabolic effect and is still considered the gold standard by Dr. Peterli, and sleeve is definitely an excellent option for a 2-step treatment.