A Case-Controlled Matched-Pair Cohort Study of Laparoscopic Roux-en-Y Gastric Bypass and Lap-Band&lt;SUP&gt;®&lt;/SUP&gt; Patients in a Single US Center with Three-Year Follow-up

Cottam, Daniel; Atkinson, James; Anderson, Aaron; Grace, Brian; Fisher, Barry

doi:10.1381/096089206776944913

Cited by 95 publications

(68 citation statements)

References 12 publications

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“…103 Weight loss outcomes consistently favor RYGB by a margin of ≈25% and show persistence to 5 years postoperatively (EWL, 47% versus 67%; P<0.001), 104 with correspondingly superior rates of diabetes, hypertension, and hyperlipidemia remission for RYGB than LAGB patients at 3 years. 105 SG is a gastric volume reduction procedure that is growing in popularity and is slightly more technically demanding. The weight loss offered by SG is superior to that of LAGB at 3 years (66% versus 48% EWL; P=0.0025), but the severity of early complications is greater than with LAGB.…”

Section: Comparison Among Bariatric Proceduresmentioning

confidence: 99%

Surgical Management of Obesity and the Relationship to Cardiovascular Disease

et al. 2013

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Section: Comparison Among Bariatric Proceduresmentioning

confidence: 99%

Surgical Management of Obesity and the Relationship to Cardiovascular Disease

et al. 2013

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“…We omitted complications whose incidence was < 0.1%. The calculated incidence of complications associated with laparoscopic bariatric surgery, obtained from the case series, 4,8,10,17,28,38,44,45,52,74,77,82,83,91,120 is summarized in Table 1; complications associated with DBS studies are shown in Table 2. 6,7,9,12,16,20,26,27,31,37,39,47,[55][56][57][58][59][60][61]64,[67][68][69]71,78,80,81,84,[86][87][88][89][96]…”

Section: Resultsmentioning

confidence: 99%

“…Although we combined short-and long-term complication rates, other studies have demonstrated that complications occurring within 30 days of surgery are more common after LRYGB, 17,120 whereas bariatric complications after 30 days are more common after LAGB; 10,45,91 port problems and band slippage, rather than the surgical placement of the band, are the most likely reasons for delayed reoperation. 17,120 Nevertheless, the superiority of LRYGB in terms of weight loss overshadows differences in complication rates when considering the overall success of LAGB versus LRYGB, as supported by the decision analysis model and several systematic reviews. 11,29,111 Decision analysis is necessarily limited by the assumptions on which the final model is based.…”

mentioning

confidence: 99%

Deep brain stimulation compared with bariatric surgery for the treatment of morbid obesity: a decision analysis study

Pisapia

Halpern²,

Williams³

et al. 2010

FOC

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Object Roux-en-Y gastric bypass is the gold standard treatment for morbid obesity, although failure rates may be high, particularly in patients with a BMI > 50 kg/m2. With improved understanding of the neuropsychiatric basis of obesity, deep brain stimulation (DBS) offers a less invasive and reversible alternative to available surgical treatments. In this decision analysis, the authors determined the success rate at which DBS would be equivalent to the two most common bariatric surgeries. Methods Medline searches were performed for studies of laparoscopic adjustable gastric banding (LAGB), laparoscopic Roux-en-Y gastric bypass (LRYGB), and DBS for movement disorders. Bariatric surgery was considered successful if postoperative excess weight loss exceeded 45% at 1-year follow-up. Using complication and success rates from the literature, the authors constructed a decision analysis model for treatment by LAGB, LRYGB, DBS, or no surgical treatment. A sensitivity analysis in which major parameters were systematically varied within their 95% CIs was used. Results Fifteen studies involving 3489 and 3306 cases of LAGB and LRYGB, respectively, and 45 studies involving 2937 cases treated with DBS were included. The operative successes were 0.30 (95% CI 0.247–0.358) for LAGB and 0.968 (95% CI 0.967–0.969) for LRYGB. Sensitivity analysis revealed utility of surgical complications in LRYGB, probability of surgical complications in DBS, and success rate of DBS as having the greatest influence on outcomes. At no values did LAGB result in superior outcomes compared with other treatments. Conclusions Deep brain stimulation must achieve a success rate of 83% to be equivalent to bariatric surgery. This high-threshold success rate is probably due to the reported success rate of LRYGB, despite its higher complication rate (33.4%) compared with DBS (19.4%). The results support further research into the role of DBS for the treatment of obesity.

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“…When gastric bypass and adjustable gastric banding have been compared, reports have cited greater weight loss and comorbidity resolution with gastric bypass at early time intervals (1-3 years), 44,45 but similar weight loss efficacy at later (5 year) time intervals. 33 Despite difficulties in comparison of studies which report results from cohorts differing in weight and comorbidity status, adjustable gastric banding seems to be a technically safer operation with lower mortality risk than other procedures, 33 principally related to the lack of risk of intestinal leakage and subsequent sepsis early after operation.…”

Section: The Modern Era Of Bariatric Surgical Procedures For Adolescentsmentioning

confidence: 99%

Bariatric surgery for pediatric extreme obesity: now or later?

2006

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Obesity is a multifactorial disease of epidemic and global proportions that poses the most significant threat to the health of our younger generations. Those who are the most extremely affected bear the largest burden of health problems. In the US, extreme obesity affects approximately 9 million adults and 2 million children, and is associated with both immediate health problems and later health risk, including premature mortality. Present medical and behavioral interventions for extreme obesity in adults and children rarely result in the significant, durable weight loss necessary to improve health outcomes, prompting a search for more aggressive measures. Weight loss (bariatric) surgery has been advocated as an intervention for those with extreme obesity. In adults, bariatric surgery results in prolonged weight control and improvement in serious obesity comorbidities, namely type 2 diabetes, dyslipidemias, hypertension and obstructive sleep apnea syndrome. A surge in weight loss operations for adolescents has been observed recently, with a threefold increase in case volumes nationwide from 2000 to 2003. Current evidence suggests that after bariatric surgery, adolescents lose significant weight and serious obesity-related medical conditions and psychosocial status are improved. Thus it is reasonable to propose that bariatric surgery performed in the adolescent period may be more effective treatment for childhood-onset extreme obesity than delaying surgery for extremely obese youth until adulthood. This position has been echoed by a number of groups and an independent systematic review. Finally, it is conceivable that bariatric surgery performed in adulthood for childhood onset extreme obesity may not be as effective for comorbidity treatment as surgery performed earlier during adolescence. The purpose of this review is to examine the evidence, which supports early rather than later use of bariatric surgery in the treatment of extreme obesity, and to present this information in light of the medical and surgical risks of bariatric surgery.

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A Case-Controlled Matched-Pair Cohort Study of Laparoscopic Roux-en-Y Gastric Bypass and Lap-Band<SUP>®</SUP> Patients in a Single US Center with Three-Year Follow-up

Cited by 95 publications

References 12 publications

Surgical Management of Obesity and the Relationship to Cardiovascular Disease

Surgical Management of Obesity and the Relationship to Cardiovascular Disease

Deep brain stimulation compared with bariatric surgery for the treatment of morbid obesity: a decision analysis study

Bariatric surgery for pediatric extreme obesity: now or later?

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