• Jennifer Reoch, Salvatore Mottillo, Avi Shimony, Kristian B Filion, Nicolas V Christou, Lawrence Joseph, Paul Poirier, and Mark J Eisenberg.
• Divisions of Cardiology and Clinical Epidemiology, Jewish General Hospital/McGill University, Quebec, Canada.
• Arch Surg. 2011 Nov 1;146(11):1314-22.

ObjectiveTo perform a systematic review and meta-analysis evaluating the risk of reoperation, wound infection, incisional hernia, anastomotic leak, and all-cause mortality associated with laparoscopic vs open bariatric surgery at a minimum of 12 months' follow-up.Data SourcesWe systematically searched the Cochrane Library, EMBASE, and MEDLINE databases through June 1, 2010, for randomized controlled trials comparing laparoscopic with open bariatric surgery.Study SelectionWe included all randomized controlled trials that reported weight loss outcomes and complications at a minimum of 12 months' follow-up and had a minimum of 50 patients. We identified 6 randomized controlled trials, which randomized 510 patients.Data ExtractionData were extracted by 2 reviewers on study design, baseline characteristics, and surgical procedure. The outcome data extracted included change in weight and body mass index and the incidence of reoperation, wound infection, incisional hernia, anastomotic leak, and all-cause mortality.Data SynthesisWe used random-effects models, which accounted for within-study and between-study variability, to estimate pooled risk ratios (95% CIs). Compared with open surgery, laparoscopic surgery was associated with lower risk of wound infection (relative risk [RR], 0.21; 95% CI, 0.07-0.65) and incisional hernia (RR, 0.11; 95% CI, 0.03-0.35). The risk of reoperation (RR, 1.06; 95% CI, 0.70-1.61), anastomotic leak (RR, 0.64; 95% CI, 0.14-2.95), and all-cause mortality (RR, 0.86; 95% CI, 0.22-3.28) may be similar for laparoscopic and open bariatric surgery.ConclusionLaparoscopic surgery may be a safer treatment than open surgery for patients requiring bariatric surgery.

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