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Laparoscopic sleeve gastrectomy is superior to endoscopic intragastric balloon as a first stage procedure for super-obese patients (BMI > or =50).
Obes Surg. 2005 May; 15(5):612-7.OS

Abstract

BACKGROUND

The treatment of patients with a BMI > or =50 kg/m2 is still controversial. Given the many co-morbidities and oftentimes fragile health of super-obese patients, surgeons experienced in bariatrics often advocate a less invasive first stage operation for these patients. This allows them enough weight loss to support a more major second-stage operation such as a gastric bypass or a biliopancreatic diversion/duodenal switch. Thus, the aim of this study was to compare laparoscopic sleeve gastrectomy (LSG) and the BioEnterics intragastric balloon (BIB) as a first-stage procedure for effective initial weight loss before more definitive surgery.

METHODS

20 patients (13 males and 7 females) who underwent LSG from May 2001 to December 2002 were compared with 57 patients (33 males and 24 females) obtained as historical controls from two large series who underwent BIB. Patients were evaluated at 6 months in terms of: weight, BMI, percent of excess weight loss (%EWL) and change in BMI.

RESULTS

There were no differences between groups for age, weight and BMI. There were no complications for patients under-going the LSG. For patients undergoing BIB, 4 patients (7%) had the balloon removed due to intolerance. The mean weight loss for patients undergoing LSG and BIB at 6 months was 45.5 vs 22.3 kg respectively, and the %EWL was 35 for LSG vs 24 for BIB. BMI decreased respectively from 69 to 53 for the LSG group and from 59 to 51 for the BIB group. Weight loss decreased co-morbidities in 90% of patients after both procedures.

CONCLUSION

Patients undergoing a LSG showed a faster and greater weight loss than those using a BIB at 6 months. Moreover, LSG is a safe procedure, with reproducible results, in contrast to the BIB which was tolerated by 93% of patients. The results indicate that both mean weight loss and %EWL were better in the LSG group, and that BMI decreased substantially more in the LSG group as well. Although the BIB procedure shows efficacy in reducing weight, the LSG group does so faster and to a greater amount, thus suggesting that this may be a superior procedure as a first stage for super-obesity.

Authors+Show Affiliations

Department of Surgery, New York Presbyterian Hospital, Weill College of Medicine of Cornell University, New York, NY 10021, USA.No affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

15946449

Citation

Milone, Luca, et al. "Laparoscopic Sleeve Gastrectomy Is Superior to Endoscopic Intragastric Balloon as a First Stage Procedure for Super-obese Patients (BMI > or =50)." Obesity Surgery, vol. 15, no. 5, 2005, pp. 612-7.
Milone L, Strong V, Gagner M. Laparoscopic sleeve gastrectomy is superior to endoscopic intragastric balloon as a first stage procedure for super-obese patients (BMI > or =50). Obes Surg. 2005;15(5):612-7.
Milone, L., Strong, V., & Gagner, M. (2005). Laparoscopic sleeve gastrectomy is superior to endoscopic intragastric balloon as a first stage procedure for super-obese patients (BMI > or =50). Obesity Surgery, 15(5), 612-7.
Milone L, Strong V, Gagner M. Laparoscopic Sleeve Gastrectomy Is Superior to Endoscopic Intragastric Balloon as a First Stage Procedure for Super-obese Patients (BMI > or =50). Obes Surg. 2005;15(5):612-7. PubMed PMID: 15946449.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Laparoscopic sleeve gastrectomy is superior to endoscopic intragastric balloon as a first stage procedure for super-obese patients (BMI > or =50). AU - Milone,Luca, AU - Strong,Vivian, AU - Gagner,Michel, PY - 2005/6/11/pubmed PY - 2005/8/3/medline PY - 2005/6/11/entrez SP - 612 EP - 7 JF - Obesity surgery JO - Obes Surg VL - 15 IS - 5 N2 - BACKGROUND: The treatment of patients with a BMI > or =50 kg/m2 is still controversial. Given the many co-morbidities and oftentimes fragile health of super-obese patients, surgeons experienced in bariatrics often advocate a less invasive first stage operation for these patients. This allows them enough weight loss to support a more major second-stage operation such as a gastric bypass or a biliopancreatic diversion/duodenal switch. Thus, the aim of this study was to compare laparoscopic sleeve gastrectomy (LSG) and the BioEnterics intragastric balloon (BIB) as a first-stage procedure for effective initial weight loss before more definitive surgery. METHODS: 20 patients (13 males and 7 females) who underwent LSG from May 2001 to December 2002 were compared with 57 patients (33 males and 24 females) obtained as historical controls from two large series who underwent BIB. Patients were evaluated at 6 months in terms of: weight, BMI, percent of excess weight loss (%EWL) and change in BMI. RESULTS: There were no differences between groups for age, weight and BMI. There were no complications for patients under-going the LSG. For patients undergoing BIB, 4 patients (7%) had the balloon removed due to intolerance. The mean weight loss for patients undergoing LSG and BIB at 6 months was 45.5 vs 22.3 kg respectively, and the %EWL was 35 for LSG vs 24 for BIB. BMI decreased respectively from 69 to 53 for the LSG group and from 59 to 51 for the BIB group. Weight loss decreased co-morbidities in 90% of patients after both procedures. CONCLUSION: Patients undergoing a LSG showed a faster and greater weight loss than those using a BIB at 6 months. Moreover, LSG is a safe procedure, with reproducible results, in contrast to the BIB which was tolerated by 93% of patients. The results indicate that both mean weight loss and %EWL were better in the LSG group, and that BMI decreased substantially more in the LSG group as well. Although the BIB procedure shows efficacy in reducing weight, the LSG group does so faster and to a greater amount, thus suggesting that this may be a superior procedure as a first stage for super-obesity. SN - 0960-8923 UR - https://www.unboundmedicine.com/medline/citation/15946449/Laparoscopic_sleeve_gastrectomy_is_superior_to_endoscopic_intragastric_balloon_as_a_first_stage_procedure_for_super_obese_patients__BMI_>_or_=50__ L2 - https://dx.doi.org/10.1381/0960892053923833 DB - PRIME DP - Unbound Medicine ER -