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Mean fourteen-year, 100% follow-up of laparoscopic adjustable gastric banding for morbid obesity.
Surg Obes Relat Dis. 2013 Sep-Oct; 9(5):753-7.SO

Abstract

BACKGROUND

Many studies of short-term to mid-term outcomes after laparoscopic adjustable gastric banding (LAGB) have been published, but reliable long-term outcome reports with a minimum follow up ≥ 10 years in a sufficient number of included patients are still scarce. The objective of this study was to evaluate the long-term results after LAGB.

METHODS

Sixty consecutive patients (44 women, 16 men) were treated for morbid obesity by LAGB between 1996 and 1999. Median age of the patients at the time of operation was 45 years (range 21-64). Median preoperative body mass index (BMI, kg/m(2)) was 45 (range 35-55). All patients were asked to adhere to a strict follow-up program. Patients' BMI and percentage excess weight loss (%EWL) were calculated in the hospital's database for bariatric patients, and excess weight was taken as the weight in kilograms above the weight at BMI of 25 kg/m(2).

RESULTS

Complete data on all 60 patients could be assessed; thus, the overall rate of follow-up was 100%. After a median (range) follow-up of 14.1 years (13.2-16.8 years), the mean BMI (SD) dropped from 45 (5) to 36 (6) kg/m(2), with a mean (SD) EWL of 49% (29). At 15 years of follow-up, 29 (48%) bands have been removed, and 38 (63%) reoperations have been performed in 29 (48%) patients. Almost 70% received further treatment for their morbid obesity after band removal. Of those patients with the band still in place at 14 years, 40% had more than 50% EWL and 20% had less than 25% EWL. There was no mortality related to the primary or revisional operations, but 2 patients died of unrelated causes.

CONCLUSIONS

Mean %EWL after LAGB after more than 14 years was fairly good-49%. However, a reoperation rate of more than 60% in 48% of the patients and a band removal rate of almost 50% may indicate that LAGB cannot be recommended as a primary procedure to the general morbidly obese population.

Authors+Show Affiliations

Department of Abdominal and Minimally Invasive Surgery, Vaasa Central Hospital, Vaasa Hospital District, Finland; University of Turku, Vaasa Central Hospital, Turku, Finland. Electronic address: mikael.victorzon@vshp.fi.No affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

24079901

Citation

Victorzon, Mikael, and Pekka Tolonen. "Mean Fourteen-year, 100% Follow-up of Laparoscopic Adjustable Gastric Banding for Morbid Obesity." Surgery for Obesity and Related Diseases : Official Journal of the American Society for Bariatric Surgery, vol. 9, no. 5, 2013, pp. 753-7.
Victorzon M, Tolonen P. Mean fourteen-year, 100% follow-up of laparoscopic adjustable gastric banding for morbid obesity. Surg Obes Relat Dis. 2013;9(5):753-7.
Victorzon, M., & Tolonen, P. (2013). Mean fourteen-year, 100% follow-up of laparoscopic adjustable gastric banding for morbid obesity. Surgery for Obesity and Related Diseases : Official Journal of the American Society for Bariatric Surgery, 9(5), 753-7. https://doi.org/10.1016/j.soard.2013.05.010
Victorzon M, Tolonen P. Mean Fourteen-year, 100% Follow-up of Laparoscopic Adjustable Gastric Banding for Morbid Obesity. Surg Obes Relat Dis. 2013;9(5):753-7. PubMed PMID: 24079901.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Mean fourteen-year, 100% follow-up of laparoscopic adjustable gastric banding for morbid obesity. AU - Victorzon,Mikael, AU - Tolonen,Pekka, Y1 - 2013/06/14/ PY - 2012/03/07/received PY - 2013/04/08/revised PY - 2013/05/12/accepted PY - 2013/10/2/entrez PY - 2013/10/2/pubmed PY - 2014/6/6/medline KW - BMI KW - Bariatric surgery KW - Excess weight loss KW - Failure KW - LAGB KW - Long-term follow-up KW - Revisions SP - 753 EP - 7 JF - Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery JO - Surg Obes Relat Dis VL - 9 IS - 5 N2 - BACKGROUND: Many studies of short-term to mid-term outcomes after laparoscopic adjustable gastric banding (LAGB) have been published, but reliable long-term outcome reports with a minimum follow up ≥ 10 years in a sufficient number of included patients are still scarce. The objective of this study was to evaluate the long-term results after LAGB. METHODS: Sixty consecutive patients (44 women, 16 men) were treated for morbid obesity by LAGB between 1996 and 1999. Median age of the patients at the time of operation was 45 years (range 21-64). Median preoperative body mass index (BMI, kg/m(2)) was 45 (range 35-55). All patients were asked to adhere to a strict follow-up program. Patients' BMI and percentage excess weight loss (%EWL) were calculated in the hospital's database for bariatric patients, and excess weight was taken as the weight in kilograms above the weight at BMI of 25 kg/m(2). RESULTS: Complete data on all 60 patients could be assessed; thus, the overall rate of follow-up was 100%. After a median (range) follow-up of 14.1 years (13.2-16.8 years), the mean BMI (SD) dropped from 45 (5) to 36 (6) kg/m(2), with a mean (SD) EWL of 49% (29). At 15 years of follow-up, 29 (48%) bands have been removed, and 38 (63%) reoperations have been performed in 29 (48%) patients. Almost 70% received further treatment for their morbid obesity after band removal. Of those patients with the band still in place at 14 years, 40% had more than 50% EWL and 20% had less than 25% EWL. There was no mortality related to the primary or revisional operations, but 2 patients died of unrelated causes. CONCLUSIONS: Mean %EWL after LAGB after more than 14 years was fairly good-49%. However, a reoperation rate of more than 60% in 48% of the patients and a band removal rate of almost 50% may indicate that LAGB cannot be recommended as a primary procedure to the general morbidly obese population. SN - 1878-7533 UR - https://www.unboundmedicine.com/medline/citation/24079901/Mean_fourteen_year_100_follow_up_of_laparoscopic_adjustable_gastric_banding_for_morbid_obesity_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1550-7289(13)00187-1 DB - PRIME DP - Unbound Medicine ER -