Weight loss outcomes after Nissen sleeve gastrectomy vs standard sleeve gastrectomy in female patients: a retrospective matched -cohort study.

INTRODUCTION: Nissen sleeve gastrectomy (NSG) is a procedure that combines SG with an antireflux component. However, its impact on weight loss outcomes remains controversial. Comparative data between SG and NSG are limited. AIM: The aim of this study was to compare weight loss after NSG and SG at a minimum of 12 months postsurgery. MATERIALS AND METHODS: This retrospective matched-cohort study included patients who underwent NSG at a high-volume bariatric center between 2023 and 2025. The NSG patients were matched at a 1:2 ratio with individuals undergoing standard SG, using propensity score matching based on age, preoperative body mass index, and date of surgery. Weight loss outcomes, including percentage of total weight loss (%TWL) and percentage of excess weight loss (%EWL), were assessed at a minimum follow-up of 12 months. Subgroup analyses were performed according to follow-up duration (<⁠20 vs ≥20 mo). RESULTS: A total of 25 patients undergoing NSG were matched with 50 SG patients. All study participants were women. At median (interquartile range) follow-up of 20.4 (16-23.1) months, SG was associated with significantly higher %TWL and %EWL, as compared with NSG (32.2% vs 29.3%; P = 0.01 and 87.3% vs 78.5%; P = 0.02, respectively). After stratification by follow-up duration, significant differences were observed only in the patients followed for less than 20 months, whereas weight loss outcomes were comparable between the procedures in the individuals followed for 20 months or longer. Operative time was significantly longer for NSG, while length of hospital stay was similar between the groups. One Clavien-Dindo grade III complication occurred in the NSG group. CONCLUSIONS: SG was associated with greater early weight loss than NSG. However, these differences diminished with longer follow-up.