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Conversion Surgery for Failed Adjustable Gastric Banding: Outcomes with Sleeve Gastrectomy vs Roux-en-Y Gastric Bypass.
Obes Surg. 2018 11; 28(11):3573-3579.OS

Abstract

OBJECTIVES

Laparoscopic adjustable gastric banding (LAGB) was once a preferred method of obesity treatment featuring a straightforward technique, removability, and good early results. In a significant proportion of patients, however, it was not a durable weight-loss procedure and has been associated with a high longer-term complication rate. The purpose of this study was to directly compare the results of conversion to laparoscopic Roux-en-Y gastric bypass (LRYGB) and laparoscopic sleeve gastrectomy (LSG) after failed LAGB.

METHODS

Post-LAGB complications and weight outcomes of conversion (absolute weight, excess weight loss [%EWL], total weight loss [%TWL]) to LSG vs LRYGB were retrospectively reviewed and statistically compared using Fisher's exact test and the independent samples t test.

RESULTS

Over a 6-year period, 74/272 (27.2%) morbidly obese LAGB patients experienced marked complications requiring band removal. Forty-nine of these patients underwent conversion by LRYGB (n = 29) or LSG (n = 20). There was no statistically significant difference in complication rates between converted procedures and no significant difference in respective EWL and TWL (6-month EWL: LRYGB, 53.6% vs LSG, 51.3% and respective TWL, 22.8 vs 21.3%; 12-month EWL, 70.1 vs 56.1%; and TWL, 30.7 vs 23.2%; p > 0.05). All conversion patients were present at each time point.

CONCLUSIONS

Outcomes for LSG vs LRYGB following failed LAGB were equally safe and effective.

Authors+Show Affiliations

Faculty of Medicine, Health Sciences University, Istanbul, Turkey. avsarfatihmehmet@gmail.com. Ankara Numune Health Practice Research Center, Mesrutiyet Street, Nu: 28/6, 06640, Kizilay, Ankara, Turkey. avsarfatihmehmet@gmail.com.Faculty of Medicine, Health Sciences University, Istanbul, Turkey. Ankara Numune Health Practice Research Center, Mesrutiyet Street, Nu: 28/6, 06640, Kizilay, Ankara, Turkey.Faculty of Medicine, Health Sciences University, Istanbul, Turkey. Ankara Numune Health Practice Research Center, Mesrutiyet Street, Nu: 28/6, 06640, Kizilay, Ankara, Turkey.School of Health Sciences, Department of Nutrition & Dietetics, Istanbul Medipol University, Istanbul, Turkey.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30022423

Citation

Avsar, Fatih Mehmet, et al. "Conversion Surgery for Failed Adjustable Gastric Banding: Outcomes With Sleeve Gastrectomy Vs Roux-en-Y Gastric Bypass." Obesity Surgery, vol. 28, no. 11, 2018, pp. 3573-3579.
Avsar FM, Sapmaz A, Uluer A, et al. Conversion Surgery for Failed Adjustable Gastric Banding: Outcomes with Sleeve Gastrectomy vs Roux-en-Y Gastric Bypass. Obes Surg. 2018;28(11):3573-3579.
Avsar, F. M., Sapmaz, A., Uluer, A., & Erdem, N. Z. (2018). Conversion Surgery for Failed Adjustable Gastric Banding: Outcomes with Sleeve Gastrectomy vs Roux-en-Y Gastric Bypass. Obesity Surgery, 28(11), 3573-3579. https://doi.org/10.1007/s11695-018-3397-3
Avsar FM, et al. Conversion Surgery for Failed Adjustable Gastric Banding: Outcomes With Sleeve Gastrectomy Vs Roux-en-Y Gastric Bypass. Obes Surg. 2018;28(11):3573-3579. PubMed PMID: 30022423.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Conversion Surgery for Failed Adjustable Gastric Banding: Outcomes with Sleeve Gastrectomy vs Roux-en-Y Gastric Bypass. AU - Avsar,Fatih Mehmet, AU - Sapmaz,Ali, AU - Uluer,Ali, AU - Erdem,Nihal Zekiye, PY - 2018/7/20/pubmed PY - 2019/10/12/medline PY - 2018/7/20/entrez KW - Conversion KW - LAGB KW - LRYGB KW - LSG KW - Laparoscopic Roux-en-Y gastric bypass KW - Laparoscopic adjustable gastric banding KW - Laparoscopic sleeve gastrectomy KW - Redo surgery SP - 3573 EP - 3579 JF - Obesity surgery JO - Obes Surg VL - 28 IS - 11 N2 - OBJECTIVES: Laparoscopic adjustable gastric banding (LAGB) was once a preferred method of obesity treatment featuring a straightforward technique, removability, and good early results. In a significant proportion of patients, however, it was not a durable weight-loss procedure and has been associated with a high longer-term complication rate. The purpose of this study was to directly compare the results of conversion to laparoscopic Roux-en-Y gastric bypass (LRYGB) and laparoscopic sleeve gastrectomy (LSG) after failed LAGB. METHODS: Post-LAGB complications and weight outcomes of conversion (absolute weight, excess weight loss [%EWL], total weight loss [%TWL]) to LSG vs LRYGB were retrospectively reviewed and statistically compared using Fisher's exact test and the independent samples t test. RESULTS: Over a 6-year period, 74/272 (27.2%) morbidly obese LAGB patients experienced marked complications requiring band removal. Forty-nine of these patients underwent conversion by LRYGB (n = 29) or LSG (n = 20). There was no statistically significant difference in complication rates between converted procedures and no significant difference in respective EWL and TWL (6-month EWL: LRYGB, 53.6% vs LSG, 51.3% and respective TWL, 22.8 vs 21.3%; 12-month EWL, 70.1 vs 56.1%; and TWL, 30.7 vs 23.2%; p > 0.05). All conversion patients were present at each time point. CONCLUSIONS: Outcomes for LSG vs LRYGB following failed LAGB were equally safe and effective. SN - 1708-0428 UR - https://www.unboundmedicine.com/medline/citation/30022423/Conversion_Surgery_for_Failed_Adjustable_Gastric_Banding:_Outcomes_with_Sleeve_Gastrectomy_vs_Roux_en_Y_Gastric_Bypass_ L2 - https://dx.doi.org/10.1007/s11695-018-3397-3 DB - PRIME DP - Unbound Medicine ER -