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Laparoscopic adjustable gastric banding versus Roux-en-Y gastric bypass: 10-year results of a prospective, randomized trial.
Surg Obes Relat Dis. 2013 May-Jun; 9(3):405-13.SO

Abstract

BACKGROUND

There are few studies of long-term outcomes for either laparoscopic adjustable gastric banding (LAGB) or laparoscopic Roux-en-Y gastric bypass (LRYGB). The objective of this study was to compare outcomes of patients randomly assigned to undergo LAGB or LRYGB at 10 years.

METHODS

LAGB, using the pars flaccida technique, and standard LRYGB were performed. From January 2000 to November 2000, 51 patients (mean age 34.0 ± 8.9 years; range 20-49) were randomly allocated to undergo either LAGB (n = 27, 5 men and 22 women; mean age 33.3 years; mean weight 120 kg; mean body mass index [BMI] 43.4 kg/m(2)) or LRYGB (n = 24, 4 men and 20 women; mean age 34.7; mean weight 120 kg; mean BMI 43.8 kg/m(2)). Data on complications, reoperations, weight, BMI, percentage of excess weight loss, and co-morbidities were collected yearly. The data were analyzed using Student's t test and Fisher's exact test, with P<.05 considered significant.

RESULTS

Five patients in the LAGB group and 3 patients in the LRYGB group were lost to follow-up. No patient died. Conversion to laparotomy was performed in 1 (4.2%) of 24 LRYGB patients. Reoperations were required in 9 (40.9%) of 22 LAGB patients and in 6 (28.6%) of the 21 LRYGB patients. At 10-year follow-up, the LRYGB patients had a greater percentage of mean excess weight loss than did the LAGB patients (69±29% versus 46±27%; P = .03).

CONCLUSION

LRYGB was superior to LAGB in term of excess weight loss results (76.2% versus 46.2%) at 10 years. However, LRYGB exposes patients to higher early complication rates than LAGB (8.3% versus 0%) and potentially lethal long-term surgical complications (internal hernia and bowel obstruction rate: 4.7%).

Authors+Show Affiliations

General and Laparoscopic Surgery Unit, S. Giovanni Bosco Hospital, Naples, Italy. luigiangrisani@chirurgiaobesita.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

23453785

Citation

Angrisani, Luigi, et al. "Laparoscopic Adjustable Gastric Banding Versus Roux-en-Y Gastric Bypass: 10-year Results of a Prospective, Randomized Trial." Surgery for Obesity and Related Diseases : Official Journal of the American Society for Bariatric Surgery, vol. 9, no. 3, 2013, pp. 405-13.
Angrisani L, Cutolo PP, Formisano G, et al. Laparoscopic adjustable gastric banding versus Roux-en-Y gastric bypass: 10-year results of a prospective, randomized trial. Surg Obes Relat Dis. 2013;9(3):405-13.
Angrisani, L., Cutolo, P. P., Formisano, G., Nosso, G., & Vitolo, G. (2013). Laparoscopic adjustable gastric banding versus Roux-en-Y gastric bypass: 10-year results of a prospective, randomized trial. Surgery for Obesity and Related Diseases : Official Journal of the American Society for Bariatric Surgery, 9(3), 405-13. https://doi.org/10.1016/j.soard.2012.11.011
Angrisani L, et al. Laparoscopic Adjustable Gastric Banding Versus Roux-en-Y Gastric Bypass: 10-year Results of a Prospective, Randomized Trial. Surg Obes Relat Dis. 2013 May-Jun;9(3):405-13. PubMed PMID: 23453785.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Laparoscopic adjustable gastric banding versus Roux-en-Y gastric bypass: 10-year results of a prospective, randomized trial. AU - Angrisani,Luigi, AU - Cutolo,Pier Paolo, AU - Formisano,Giampaolo, AU - Nosso,Gabriella, AU - Vitolo,Giuliana, Y1 - 2013/01/31/ PY - 2013/11/05/received PY - 2012/11/05/revised PY - 2013/11/30/accepted PY - 2013/3/5/entrez PY - 2013/3/5/pubmed PY - 2014/1/22/medline SP - 405 EP - 13 JF - Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery JO - Surg Obes Relat Dis VL - 9 IS - 3 N2 - BACKGROUND: There are few studies of long-term outcomes for either laparoscopic adjustable gastric banding (LAGB) or laparoscopic Roux-en-Y gastric bypass (LRYGB). The objective of this study was to compare outcomes of patients randomly assigned to undergo LAGB or LRYGB at 10 years. METHODS: LAGB, using the pars flaccida technique, and standard LRYGB were performed. From January 2000 to November 2000, 51 patients (mean age 34.0 ± 8.9 years; range 20-49) were randomly allocated to undergo either LAGB (n = 27, 5 men and 22 women; mean age 33.3 years; mean weight 120 kg; mean body mass index [BMI] 43.4 kg/m(2)) or LRYGB (n = 24, 4 men and 20 women; mean age 34.7; mean weight 120 kg; mean BMI 43.8 kg/m(2)). Data on complications, reoperations, weight, BMI, percentage of excess weight loss, and co-morbidities were collected yearly. The data were analyzed using Student's t test and Fisher's exact test, with P<.05 considered significant. RESULTS: Five patients in the LAGB group and 3 patients in the LRYGB group were lost to follow-up. No patient died. Conversion to laparotomy was performed in 1 (4.2%) of 24 LRYGB patients. Reoperations were required in 9 (40.9%) of 22 LAGB patients and in 6 (28.6%) of the 21 LRYGB patients. At 10-year follow-up, the LRYGB patients had a greater percentage of mean excess weight loss than did the LAGB patients (69±29% versus 46±27%; P = .03). CONCLUSION: LRYGB was superior to LAGB in term of excess weight loss results (76.2% versus 46.2%) at 10 years. However, LRYGB exposes patients to higher early complication rates than LAGB (8.3% versus 0%) and potentially lethal long-term surgical complications (internal hernia and bowel obstruction rate: 4.7%). SN - 1878-7533 UR - https://www.unboundmedicine.com/medline/citation/23453785/Laparoscopic_adjustable_gastric_banding_versus_Roux_en_Y_gastric_bypass:_10_year_results_of_a_prospective_randomized_trial_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1550-7289(13)00028-2 DB - PRIME DP - Unbound Medicine ER -