Disappointing mid-term results after laparoscopic gastric banding in young patients

Lanthaler, Monika; Sieb, Michael; Strasser, Stefan; Weiß, Helmut; Aigner, Franz; Nehoda, Hermann

doi:10.1016/j.soard.2008.08.007

Cited by 25 publications

(18 citation statements)

References 29 publications

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“…In Europe, where there is greater experience with the band, several groups have reported higher reoperative rates for dysphagia, band migration, port displacement, and infection in younger patients. 44,45 More recently, an Australian group reported a 33% reoperation rate for patients aged 14 to 18 years who underwent LAGB in a prospective randomized controlled trial. 13 Many centers have abandoned gastric banding because of poor long-term results, the need for frequent adjustments, the complications associated with implantation of a foreign body, and concerns with chronic esophageal obstruction.…”

Section: Figurementioning

confidence: 99%

Trends and Outcomes of Adolescent Bariatric Surgery in California, 2005–2007

Jen

Rickard²,

Shew³

et al. 2010

Pediatrics

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WHAT'S KNOWN ON THIS SUBJECT:There has been a dramatic increase in the use of adolescent bariatric surgery. However, previous studies were unable to distinguish laparoscopic versus open procedures. Furthermore, the use of laparoscopic adjustable gastric banding (LAGB) has not been studied on a population level. WHAT THIS STUDY ADDS:The rate of LAGB increased sevenfold from 2005 to 2007 with a corresponding decrease in the rate of laparoscopic Roux-en-Y gastric bypass. Furthermore, white adolescents represented only 28% of those who were overweight but accounted for 65% of the procedures.abstract OBJECTIVE: The goal of this study was to evaluate trends, and outcomes of adolescents who undergo bariatric surgery. PATIENTS AND METHODS: RESULTS:Overall, 590 adolescents (aged 13-20 years) underwent bariatric surgery in 86 hospitals. White adolescents represented 28% of those who were overweight but accounted for 65% of the procedures. Rates of laparoscopic adjustable gastric banding (LAGB) increased 6.9-fold from 0.3 to 1.5 per 100 000 population (P Ͻ .01), whereas laparoscopic Roux-en-Y gastric bypass (LRYGB) rates decreased from 3.8 to 2.7 per 100 000 population (P Ͻ .01). Self-payers were more likely to undergo LAGB (relative risk [RR]: 3.51 [95% confidence interval: 2.11-5.32]) and less likely to undergo LRYGB (RR: 0.45 [95% confidence interval: 0.33-0.58]) compared with privately insured adolescents. The rate of major in-hospital complication was 1%, and no deaths were reported. Of the patients who received LAGB, 4.7% had band revision/removal. In contrast, 2.9% of those who received LRYGB required reoperations. CONCLUSIONS:White adolescent girls disproportionately underwent bariatric surgery. Although LAGB has not been approved by the US Food and Drug Administration for use in children, its use has increased dramatically. There was a complication rate and no deaths. Long-term studies are needed to fully assess the efficacy, safety, and health care costs of these procedures in adolescents.

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Section: Figurementioning

confidence: 99%

Trends and Outcomes of Adolescent Bariatric Surgery in California, 2005–2007

Jen

Rickard²,

Shew³

et al. 2010

Pediatrics

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“…[22][23][24][25] It involves placing an adjustable band around the stomach that restricts the passage of food. The band tightness is adjusted by needle injection of fluid into a port that is located in the subcutaneous tissue.…”

Section: General Requirementsmentioning

confidence: 99%

“…7,8 The durability of gastric banding in younger patients has also been questioned because it involves insertion of a foreign body, which is likely to malfunction and ultimately require replacement or removal. 23,24 In the US, sleeve gastrectomy has become increasingly popular in the last few years. This promising procedure is a restrictive procedure that involves resection of approximately 70% of the stomach ( Figure 2C).…”

Section: General Requirementsmentioning

confidence: 99%

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Treatment of adolescents with morbid obesity with bariatric procedures and anti-obesity pharmacological agents

Um¹,

Slusser²,

DeUgarte

2011

OAS

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Adolescent obesity is a growing health concern that can have immense physical and psychological impact. Treatment of morbidly obese adolescents should include a multidisciplinary team to address medical comorbidities, diet, physical activity, mental health, and behavior modification. Anti-obesity pharmacologic agents have a limited role in the treatment of adolescents because of concerns with side effects, safety, and efficacy. Orlistat (GlaxoSmithKline, Moon Township, PA) is the only approved medication for weight-loss in adolescents. However, it is associated with gastrointestinal side effects and its long-term efficacy is unknown. Bariatric surgery is the most effective therapy to treat morbid obesity. However, adolescents must meet rigorous criteria and have appropriate cognitive, psychological, and social clearance before being considered for surgical intervention. Gastric bypass remains the gold standard bariatric operation. The adjustable gastric band is not FDA-approved for use in patients under 18 years of age. Sleeve gastrectomy is a promising procedure for adolescents because it avoids an intestinal bypass and the implantation of a foreign body. Prospective longitudinal assessment of bariatric surgery procedures is required to determine long-term outcomes. In this manuscript, we review the treatment options, efficacy, and impact on quality of life for morbidly obese adolescents.

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“…Bölter et al [8] установили, что через 6 мес после БО 75% пациентов были недовольны результатом операции и предъявляли жалобы на отсутствие психологической поддержки и появление новых соматических и психо-логических симптомов. Lanthaler et al [29], применяя систему анализа и отчетности для оценки результатов БО (BAROS), показал, что через 7 лет после БО, не-смотря на сохраняющийся эффект в отношении МТ, результаты хирургического вмешательства являются неудовлетворительными у 40% оперированных, удов-летворительными -у 4%, хорошими -у 28%, очень хо-рошими -у 20% и отличными -у 8%. Таким образом, после хирургического вмешательства психических рас-стройств у больных МО, по-видимому, не становится меньше, однако их спектр может трансформироваться, а вместо старых проблем появиться новые.…”

Section: таблицаunclassified

Problemy lecheniya patsientov s morbidnym ozhireniem

Старостина¹

2011

Obes. metabol.

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Старостина Е.Г.Резюме. В статье с позиций доказательной медицины проанализированы подходы к лечению морбидного ожирения, включая хирургические вмешательства, направленные на снижение массы тела; дан сопоставительный анализ эффективности и без-опасности немедикаментозной и медикаментозной терапии, а также различных типов бариатрических операций. Подробно обсуждаются вопросы безопасности хирургического метода лечения морбидного ожирения, включая диагностику, лечение и профилактику дефицита витаминов и минералов. Особое внимание уделено проблеме высокой распространенности пси-хических расстройств у пациентов с морбидным ожирением, их роли в генезе морбидного ожирения, влиянию на результаты хирургического лечения и возможную неудовлетворенность пациентов его результатами. Подчеркивается необходимость тщательного отбора пациентов на бариатрические операции с учетом их психического состояния и надлежащей организации последующего пожизненного наблюдения оперированных пациентов. Ключевые слова: морбидное ожирение, лечение, бариат рические операции, психические расстройства Resume. The article describes evidence-based approaches to treatment of morbid obesity, including surgical interventions designated for bodyweight reduction and provides comparative analysis of efficacy and safety of lifestyle interventions, medical treatment and various types of bariatric surgery. Detailed description of diagnosis, treatment and prevention of post-surgical vitamin and mineral deficiencies is given. Special attention is paid to high prevalence of mental disorders in patients with morbid obesity, their role in its development, their influence on outcomes of surgical intervention and potential patient dissatisfaction with its results. Necessity of thorough selection of patients for bariatric surgery is emphasized, with assessment of their mental state and proper organization of subsequent life-long follow-up after operation.

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Disappointing mid-term results after laparoscopic gastric banding in young patients

Cited by 25 publications

References 29 publications

Trends and Outcomes of Adolescent Bariatric Surgery in California, 2005–2007

Trends and Outcomes of Adolescent Bariatric Surgery in California, 2005–2007

Treatment of adolescents with morbid obesity with bariatric procedures and anti-obesity pharmacological agents

Problemy lecheniya patsientov s morbidnym ozhireniem

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