A prospective study comparing 5-year results between superobese and non-superobese patients after laparoscopic adjustable gastric banding.

Abstract

IntroductionLaparoscopic adjustable gastric banding (LAGB) is considered to be the least invasive, reversible, and the safest bariatric operation regarding mortality and morbidity, and its application to high-risk superobese (SO) individuals seems rational.AimThere are differing viewpoints regarding the effectiveness of LAGB in superobese (BMI > 50 kg/m2) patients. The aim of this study was to compare the safety and efficacy of LAGB in SO and non-superobese (NSO) patients in the long term (> 5 years).Material and methodsWe undertook a prospective single-center study to compare the safety and efficacy of LAGB in SO and NSO patients after 5 years. One hundred and three morbidly obese patients underwent LAGB in the period from January 2009 to January 2010. Sixty-four of the patients were NSO and 39 SO. After 5 years, we evaluated their weight loss, comorbidities, complications, and quality of life.ResultsA total of 90 of 103 patients (87.3%) completed the 5-year follow-up. The percentage excess weight loss was 50.4% in the NSO and 38.8% in the SO group (p = 0.072). The proportion of patients who lost > 50% excess weight was significantly larger in the NSO group (p = 0.045). There were significantly more patients in the NSO group whose metabolic syndrome had resolved (p < 0.001). There were no differences regarding the resolution of other comorbidities and postoperative complications.ConclusionsThis study suggests that LAGB can lead to substantial and long-lasting weight loss after 5 years. Our study found that SO patients demonstrate inferior weight loss results, and lower overall BAROS scores; thus we do not support the primary use of LAGB in SO patients.

Effectiveness and Safety of Adjustable Gastric Banding in Morbidly Obese Patients After 5 Years of Follow-up

“…The %EWL at 5 and 10 years was 30% and 16.9%, respectively, while LAGB failure occurred in 57% of patients, and a higher baseline BMI was the only independently associated factor. In a recent prospective study comparing 5-year results between superobese and non-superobese patients after LAGB, the authors demonstrated that LAGB could lead to long-lasting weight loss after 5 years, but superobese patients had significantly inferior weight loss results than patients with a BMI ≤ 50 [28].…”