Is there an indication left for gastric band? A single center experience on 178 patients with a follow-up of 10 years.
Band removal
Gastric band
LAGB
Long term results
Journal
Updates in surgery
ISSN: 2038-3312
Titre abrégé: Updates Surg
Pays: Italy
ID NLM: 101539818
Informations de publication
Date de publication:
Apr 2021
Apr 2021
Historique:
received:
15
06
2020
accepted:
23
07
2020
pubmed:
2
8
2020
medline:
16
10
2021
entrez:
2
8
2020
Statut:
ppublish
Résumé
Laparoscopic Adjustable Gastric Banding (LAGB) has been widely performed in the past at our university bariatric center. Aim of this study was to retrospectively assess long term outcomes of LAGB at our university hospital, with special regard to non-response (EWL < 25%) and rate of band removal. Retrospective search of prospectively maintained database of our university bariatric center was carried out to find all consecutive patients that had undergone LAGB at our department with a minimum follow-up of 10 years. Collected data were sex, age, body mass index (BMI), obesity related diseases remission, complications and weight loss. After 10 years, patients with the band (n = 144) in place had a BMI of 35.2 ± 7.5 kg/m2, while %EWL and % TWL were 40.8 ± 52.4 and 18.9 ± 20.7. Seventy-four (41.6%) achieved a success (%EWL > 50), while 38 (21.3%) were non-responders (%EWL < 25), 32 (18%) had an insufficient weight loss (25 < %EWL < 50) and 34 (19.1%) underwent band removal. Among these, 6 (3.4%) were removed for complications and 28 (15.7%) for insufficient weight loss. Weight regain occurred in 38 out of 144 (26.4%) subjects with the band in place at 10 years. Only one case of early vomiting with readmission for medical treatment was recorded. Slippage, erosion/migration and port/tube complications occurred in 4 (2.2%), 2(1.1%) and 9(5%) cases respectively. LAGB is a safe and moderately effective bariatric procedure but it showed disappointing rates of removal, non-response and remission from comorbidities. However, LAGB could still be proposed for selected/motivated patients.
Sections du résumé
BACKGROUND
BACKGROUND
Laparoscopic Adjustable Gastric Banding (LAGB) has been widely performed in the past at our university bariatric center. Aim of this study was to retrospectively assess long term outcomes of LAGB at our university hospital, with special regard to non-response (EWL < 25%) and rate of band removal.
METHODS
METHODS
Retrospective search of prospectively maintained database of our university bariatric center was carried out to find all consecutive patients that had undergone LAGB at our department with a minimum follow-up of 10 years. Collected data were sex, age, body mass index (BMI), obesity related diseases remission, complications and weight loss.
RESULTS
RESULTS
After 10 years, patients with the band (n = 144) in place had a BMI of 35.2 ± 7.5 kg/m2, while %EWL and % TWL were 40.8 ± 52.4 and 18.9 ± 20.7. Seventy-four (41.6%) achieved a success (%EWL > 50), while 38 (21.3%) were non-responders (%EWL < 25), 32 (18%) had an insufficient weight loss (25 < %EWL < 50) and 34 (19.1%) underwent band removal. Among these, 6 (3.4%) were removed for complications and 28 (15.7%) for insufficient weight loss. Weight regain occurred in 38 out of 144 (26.4%) subjects with the band in place at 10 years. Only one case of early vomiting with readmission for medical treatment was recorded. Slippage, erosion/migration and port/tube complications occurred in 4 (2.2%), 2(1.1%) and 9(5%) cases respectively.
CONCLUSION
CONCLUSIONS
LAGB is a safe and moderately effective bariatric procedure but it showed disappointing rates of removal, non-response and remission from comorbidities. However, LAGB could still be proposed for selected/motivated patients.
Identifiants
pubmed: 32737822
doi: 10.1007/s13304-020-00858-8
pii: 10.1007/s13304-020-00858-8
pmc: PMC8005389
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
657-662Références
Wilkinson LH, Peloso OA (1981) Gastric (reservoir) reduction for morbid obesity. Arch Surg 116:602–605
doi: 10.1001/archsurg.1981.01380170082014
Kolle K, Bo O, Stadaas J (1982) Gastric banding. In: OMGI 7th Congress, Stockholm, vol 145, p 37
Molina M, Oria HE (1983) Gastric segmentation: a new, safe, effective, simple, readily revised and fully reversible surgical procedure for the correction of morbid obesity. In: 6th Bariatric Surgery Colloquium, Iowa City, IA, pp 2–3
Hallberg D, Forsell O (1985) Ballongband vid behandling av massiv överwikt. Svinsk Kirurgi 344:106–108
Kuzmak LI (1986) Silicone gastric banding: a simple and effective operation for morbid obesity. Contemp Surg 28:13–18
Vinzens F, Kilchenmann A, Zumstein V, Slawik M, Gebhart M, Peterli R (2017) Long-term outcome of laparoscopic adjustable gastric banding (LAGB): results of a Swiss single-center study of 405 patients with up to 18 years' follow-up. Surg Obes Relat Dis 13(8):1313–1319
doi: 10.1016/j.soard.2017.04.030
Buchwald H, Oien DM (2013) Metabolic/bariatric surgery worldwide 2011. Obes Surg 23(4):427–436
doi: 10.1007/s11695-012-0864-0
Angrisani L, Santonicola A, Iovino P et al (2017) Erratum to: bariatric surgery and endoluminal procedures: IFSO worldwide survey 2014. Obes Surg 27(9):2290–2292
doi: 10.1007/s11695-017-2773-8
Angrisani L, Santonicola A, Iovino P et al (2018) IFSO worldwide survey 2016: primary, endoluminal, and revisional procedures. Obes Surg 28(12):3783–3794
doi: 10.1007/s11695-018-3450-2
Musella M, Milone M, Gaudioso D et al (2014) A decade of bariatric surgery. What have we learned? Outcome in 520 patients from a single institution. Int J Surg 12(Suppl 1):S183–S188. https://doi.org/10.1016/j.ijsu.2014.05.012
doi: 10.1016/j.ijsu.2014.05.012
pubmed: 24861545
Brolin R, Kenler HA, Gorman RC et al (1989) The dilemma of outcome assessment after operations for morbid obesity. Surgery 105:337–346
pubmed: 2922674
American Diabetes Association (2010) Diagnosis and classification of diabetes mellitus. Diabetes Care 33(Suppl 1):S62–S69
doi: 10.2337/dc10-S062
National Institute for Health and Clinical excellence. https://www.nice.org.uk/guidance/ng136/chapter/recommendations . NICE guideline [NG136] Published date: August 2019.
Goldstein LB, Bushnell CD, Adams RJ et al (2011) Guidelines for the primary prevention of stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 42(2):517–584
doi: 10.1161/STR.0b013e3181fcb238
Beitner MM, Ren-Fielding CJ, Fielding GA (2016) Reducing complications with improving gastric band design. Surg Obes Relat Dis 12(1):150–156
doi: 10.1016/j.soard.2015.08.520
Lyass S, Cunneen SA, Hagiike M et al (2005) Device-related reoperations after laparoscopic adjustable gastric banding. Am Surg 71(9):738–743
doi: 10.1177/000313480507100909
Egberts K, Brown WA, O’Brien PE (2011) Systematic review of erosion after laparoscopic adjustable gastric banding. Obes Surg 21(8):1272–1279
doi: 10.1007/s11695-011-0430-1
Kodner C, Hartman DR (2014) Complications of adjustable gastric banding surgery for obesity. Am Fam Physician 89(10):813–818
pubmed: 24866217
Sharples AJ, Charalampakis V, Daskalakis M, Tahrani AA, Singhal R (2017) Systematic review and meta-analysis of outcomes after revisional bariatric surgery following a failed adjustable gastric band. Obes Surg 27(10):2522–2536
doi: 10.1007/s11695-017-2677-7
Magouliotis DE, Tasiopoulou VS, Svokos AA, Svokos KA, Sioka E, Zacharoulis D (2017) Roux-En-Y gastric bypass versus sleeve gastrectomy as revisional procedure after adjustable gastric band: a systematic review and meta-analysis. Obes Surg 27(5):1365–1373
doi: 10.1007/s11695-017-2644-3
Lundberg PW, Gotsch A, Kim E, Claros L, Stotlzfus J, El Chaar M (2019) Safety of one-stage conversion surgery after failed gastric band: our experience and review of the literature. Updates Surg 71(3):445–450
doi: 10.1007/s13304-018-0598-1
Angrisani L, Vitiello A, Santonicola A, Hasani A, De Luca M, Iovino P (2017) Roux-en-Y gastric bypass versus sleeve gastrectomy as revisional procedures after adjustable gastric band: 5-year outcomes. Obes Surg 27(6):1430–1437
doi: 10.1007/s11695-016-2502-8
O'Brien PE, McPhail T, Chaston TB, Dixon JB (2006) Systematic review of medium-term weight loss after bariatric operations. Obes Surg 16(8):1032–1040
doi: 10.1381/096089206778026316
Naef M, MoutonWG NU et al (2010) Graft survival and complications after laparoscopic gastric banding for morbid obesity—lessons learned from a 12-year experience. Obes Surg 20(9):1206–1214
doi: 10.1007/s11695-010-0205-0
Mittermair RP, Obermuller S, Perathoner A et al (2009) Results and complications after Swedish adjustable gastric banding-10 years experience. Obes Surg 19(12):1636–1641
doi: 10.1007/s11695-009-9967-7
Froylich D, Abramovich-Segal T, Pascal G et al (2018) Long-term (over 10 years) retrospective follow-up of laparoscopic adjustable gastric banding. Obes Surg 28(4):976–980 (published correction appears in Obes Surg. 2017 Dec 1)
doi: 10.1007/s11695-017-2952-7
Arapis K, Tammaro P, Parenti LR et al (2017) Long-term results after laparoscopic adjustable gastric banding for morbid obesity: 18-year follow-up in a single university unit. Obes Surg 27(3):630–640
doi: 10.1007/s11695-016-2309-7
Shen X, Zhang X, Bi J, Yin K (2015) Long-term complications requiring reoperations after laparoscopic adjustable gastric banding: a systematic review. Surg Obes Relat Dis 11(4):956–964
doi: 10.1016/j.soard.2014.11.011
Nguyen NT, Kim E, Vu S, Phelan M (2018) Ten-year outcomes of a prospective randomized trial of laparoscopic gastric bypass versus laparoscopic gastric banding. Ann Surg 268(1):106–113
doi: 10.1097/SLA.0000000000002348
Tsai C, Zehetner J, Beel J, Steffen R (2019) Long-term outcomes and frequency of reoperative bariatric surgery beyond 15 years after gastric banding: a high band failure rate with safe revisions. Surg Obes Relat Dis 15(6):900–907
doi: 10.1016/j.soard.2019.03.017
Kowalewski PK, Olszewski R, Kwiatkowski A, Gałązka-Świderek N, Cichoń K, Paśnik K (2017) Life with a gastric band. Long-term outcomes of laparoscopic adjustable gastric banding-a retrospective study. Obes Surg 27(5):1250–1253
doi: 10.1007/s11695-016-2435-2
Lazzati A, De Antonio M, Paolino L et al (2017) Natural history of adjustable gastric banding: lifespan and revisional rate: a nationwide study on administrative data on 53,000 patients. Ann Surg 265(3):439–445
doi: 10.1097/SLA.0000000000001879
Vitiello A, Pilone V, Ferraro L, Forestieri P (2018) Is the sleeve gastrectomy always a better procedure? Five-year results from a retrospective matched case-control study. Obes Surg 28(8):2333–2338
doi: 10.1007/s11695-018-3161-8
Peña AS, Delko T, Couper R et al (2017) Laparoscopic adjustable gastric banding in Australian adolescents: should it be done? Obes Surg 27(7):1667–1673
doi: 10.1007/s11695-017-2544-6
Picot J, Jones J, Colquitt JL, Loveman E, Clegg AJ (2012) Weight loss surgery for mild to moderate obesity: a systematic review and economic evaluation. Obes Surg 22(9):1496–1506
doi: 10.1007/s11695-012-0679-z
Lauti M, Kularatna M, Hill AG, MacCormick AD (2016) Weight regain following sleeve gastrectomy-a systematic review. Obes Surg 26(6):1326–1334
doi: 10.1007/s11695-016-2152-x
Tran DD, Nwokeabia ID, Purnell S et al (2016) Revision of roux-en-y gastric bypass for weight regain: a systematic review of techniques and outcomes. Obes Surg 26(7):1627–1634
doi: 10.1007/s11695-016-2201-5
Elder K, Wolfe B (2007) Bariatric surgery: a review of procedures and outcomes. Gastroenterology 132(6):2253–2271
doi: 10.1053/j.gastro.2007.03.057
O'Brien PE, Hindle A, Brennan L et al (2019) Long-term outcomes after bariatric surgery: a systematic review and meta-analysis of weight loss at 10 or more years for all bariatric procedures and a single-centre review of 20-year outcomes after adjustable gastric banding. Obes Surg 29(1):3–14
doi: 10.1007/s11695-018-3525-0
Zhou R, Poirier J, Torquati A, Omotosho P (2019) Short-term outcomes of conversion of failed gastric banding to laparoscopic sleeve gastrectomy or Roux-En-Y gastric bypass: a meta-analysis. Obes Surg 29(2):420–425
doi: 10.1007/s11695-018-3538-8
Piazza L, Di Stefano C, Ferrara F, Bellia A, Vacante M, Biondi A (2015) Revision of failed primary adjustable gastric banding to mini-gastric bypass: results in 48 consecutive patients. Updates Surg 67(4):433–437
doi: 10.1007/s13304-015-0335-y
Musella M, Bruni V, Greco F et al (2019) Conversion from laparoscopic adjustable gastric banding (LAGB) and laparoscopic sleeve gastrectomy (LSG) to one anastomosis gastric bypass (OAGB): preliminary data from a multicenter retrospective study. Surg Obes Relat Dis 15(8):1332–1339
doi: 10.1016/j.soard.2019.05.026
Rossi F, Bellini G, Luongo L et al (2016) Cannabinoid receptor 2 as antiobesity target: inflammation, fat storage, and browning modulation. J Clin Endocrinol Metab 101(9):3469–3478. https://doi.org/10.1210/jc.2015-4381
doi: 10.1210/jc.2015-4381
pubmed: 27294325
Del Genio G, Limongelli P, Del Genio F, Motta G, Docimo L, Testa D (2016) Sleeve gastrectomy improves obstructive sleep apnea syndrome (OSAS): 5-year longitudinal study. Surg Obes Relat Dis 12(1):70–74. https://doi.org/10.1016/j.soard.2015.02.020
doi: 10.1016/j.soard.2015.02.020
pubmed: 25862184