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A prospective comparison of vertical banded gastroplasty and Roux-en-Y gastric bypass in a non-superobese population.

Abstract

BACKGROUND

In the non-superobese population, consensus is currently unavailable in bariatric surgery. We report the results of a prospective comparison of vertical banded gastroplasty (VBG) and Roux-en-Y gastric bypass (RYGBP) in a non-superobese population.

METHODS

From 1994 to 2000, 179 patients with clinically severe obesity underwent various surgical procedures in our department. During this time a prospective study was undertaken in order to compare VBG with RYGBP in morbidly obese patients with a BMI <50 kg/m2. Based on specific criteria including eating behavior, 68 patients were selected to undergo RYGBP and 35 VBG. All patients have undergone complete follow-up evaluation at 1, 3, 6, and 12 months postoperatively and every year thereafter.

RESULTS

All patients have now completed their 5th postoperative year. Mean follow-up period to date is 96.5+/-12.2 months for VBG and 67.6+/-11.3 months for RYGBP. 3 patients (8.6%) in the VBG group and 9 patients (13.2%) in the RYGBP group are lost to follow-up. Mean excess weight loss (EWL) was always better in the RYGBP group (P=0.0013). The percentage of failure, defined as EWL <25%, was not significantly different between the two procedures. No statistically significant differences were observed between the 2 groups in the total number of non-metabolic complications, and the only statistically significant difference observed in metabolic complications was vitamin B12 deficiency after RYGBP. Frequency of vomiting was significantly less and quality of eating significantly better in RYGBP than in VBG patients.

CONCLUSION

This prospective long-term study, with nearly complete follow-up, suggests that in the non-superobese population, preoperative eating habits may play a role in choosing the most appropriate bariatric operation for each patient. Although RYGBP is associated with better mean weight loss outcomes, the percentage of patients who achieved and maintained > or = 50% EWL after VBG in this pre-selected patient population was not significantly different. Each type of operation has advantages and disadvantages, and, if properly chosen, a purely restrictive procedure can be successful for some patients. Therefore, it can be said that the decision regarding which bariatric procedure to perform in non-superobese patients must be based on in-depth preoperative evaluation as well as the patients' own preferences and outcome expectations.

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  • Authors+Show Affiliations

    ,

    Department of Surgery, Nutrition Support and Morbid Obesity Unit, School of Medicine, University of Patras, Greece. fkalfar@med.upatras.gr

    , , ,

    Source

    Obesity surgery 16:2 2006 Feb pg 151-8

    MeSH

    Adult
    Age Factors
    Anastomosis, Roux-en-Y
    Body Mass Index
    Cohort Studies
    Female
    Follow-Up Studies
    Gastric Bypass
    Gastroplasty
    Humans
    Male
    Obesity, Morbid
    Postoperative Complications
    Probability
    Prospective Studies
    Quality of Life
    Risk Assessment
    Sensitivity and Specificity
    Severity of Illness Index
    Sex Factors
    Treatment Outcome
    Weight Loss

    Pub Type(s)

    Comparative Study
    Journal Article

    Language

    eng

    PubMed ID

    16469216

    Citation

    Kalfarentzos, Fotis, et al. "A Prospective Comparison of Vertical Banded Gastroplasty and Roux-en-Y Gastric Bypass in a Non-superobese Population." Obesity Surgery, vol. 16, no. 2, 2006, pp. 151-8.
    Kalfarentzos F, Skroubis G, Kehagias I, et al. A prospective comparison of vertical banded gastroplasty and Roux-en-Y gastric bypass in a non-superobese population. Obes Surg. 2006;16(2):151-8.
    Kalfarentzos, F., Skroubis, G., Kehagias, I., Mead, N., & Vagenas, K. (2006). A prospective comparison of vertical banded gastroplasty and Roux-en-Y gastric bypass in a non-superobese population. Obesity Surgery, 16(2), pp. 151-8.
    Kalfarentzos F, et al. A Prospective Comparison of Vertical Banded Gastroplasty and Roux-en-Y Gastric Bypass in a Non-superobese Population. Obes Surg. 2006;16(2):151-8. PubMed PMID: 16469216.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - A prospective comparison of vertical banded gastroplasty and Roux-en-Y gastric bypass in a non-superobese population. AU - Kalfarentzos,Fotis, AU - Skroubis,George, AU - Kehagias,Ioannis, AU - Mead,Nancy, AU - Vagenas,Kostas, PY - 2006/2/14/pubmed PY - 2006/6/10/medline PY - 2006/2/14/entrez SP - 151 EP - 8 JF - Obesity surgery JO - Obes Surg VL - 16 IS - 2 N2 - BACKGROUND: In the non-superobese population, consensus is currently unavailable in bariatric surgery. We report the results of a prospective comparison of vertical banded gastroplasty (VBG) and Roux-en-Y gastric bypass (RYGBP) in a non-superobese population. METHODS: From 1994 to 2000, 179 patients with clinically severe obesity underwent various surgical procedures in our department. During this time a prospective study was undertaken in order to compare VBG with RYGBP in morbidly obese patients with a BMI <50 kg/m2. Based on specific criteria including eating behavior, 68 patients were selected to undergo RYGBP and 35 VBG. All patients have undergone complete follow-up evaluation at 1, 3, 6, and 12 months postoperatively and every year thereafter. RESULTS: All patients have now completed their 5th postoperative year. Mean follow-up period to date is 96.5+/-12.2 months for VBG and 67.6+/-11.3 months for RYGBP. 3 patients (8.6%) in the VBG group and 9 patients (13.2%) in the RYGBP group are lost to follow-up. Mean excess weight loss (EWL) was always better in the RYGBP group (P=0.0013). The percentage of failure, defined as EWL <25%, was not significantly different between the two procedures. No statistically significant differences were observed between the 2 groups in the total number of non-metabolic complications, and the only statistically significant difference observed in metabolic complications was vitamin B12 deficiency after RYGBP. Frequency of vomiting was significantly less and quality of eating significantly better in RYGBP than in VBG patients. CONCLUSION: This prospective long-term study, with nearly complete follow-up, suggests that in the non-superobese population, preoperative eating habits may play a role in choosing the most appropriate bariatric operation for each patient. Although RYGBP is associated with better mean weight loss outcomes, the percentage of patients who achieved and maintained > or = 50% EWL after VBG in this pre-selected patient population was not significantly different. Each type of operation has advantages and disadvantages, and, if properly chosen, a purely restrictive procedure can be successful for some patients. Therefore, it can be said that the decision regarding which bariatric procedure to perform in non-superobese patients must be based on in-depth preoperative evaluation as well as the patients' own preferences and outcome expectations. SN - 0960-8923 UR - https://www.unboundmedicine.com/medline/citation/16469216/A_prospective_comparison_of_vertical_banded_gastroplasty_and_Roux_en_Y_gastric_bypass_in_a_non_superobese_population_ L2 - https://dx.doi.org/10.1381/096089206775565096 DB - PRIME DP - Unbound Medicine ER -