Italian Group for Lap-Band System®: Results of Multicenter Study on Patients with BMI ≤35 kg/m<SUP>2</SUP>

Abstract

Although surgical indications for BMI < or = 35 remain questionable, the Lap-Band in this study demonstrated that all but 1 patient achieved normal weight, and most lost their co-morbidities with a very low mortality rate.

Early U.S. outcomes after laparoscopic adjustable gastric banding in patients with a body mass index less than 35 kg/m2

“…Thus, although patients with a BMI less than 35 kg/ m 2 are not candidates for bariatric surgery under the current NIH guidelines, these patients are not immune to the effects of obesity. Emerging data suggest that the indications for bariatric surgery should be expanded to patients with a BMI lower than 35 kg/m 2 [6,7]. Our study adds to this data and shows that LAGB is an effective surgical option for patients with a BMI lower than 35 kg/m 2 in terms of weight loss outcomes (70% EWL at 2 years) as well as comorbidity resolution and improvement.…”

“…Angrisani et al [6] published compelling results for patients having BMI lower than 35 kg/m 2 , with 99% of these patients achieving normal weight and 89% experiencing resolution of comorbidities after gastric banding. O'Brien et al [7,8] recently have published two landmark, randomized controlled studies of patients with a BMI of 30 to 40 kg/m 2 assigned to either lap-band placement or an intensive medical therapy program.…”

“…Fobi et al [15] reported favorable outcomes for 50 patients with a BMI of 32 to 40 kg/m 2 who underwent gastric bypass. Angrisani et al [6] reported on 210 patients with a BMI lower than 35 kg/m 2 who underwent LAGB. Weight loss was sustained during 5 years of follow-up evaluation (99% achieved normal weight), and comorbidities were completely resolved after 1 year for 89.1% of the patients.…”

Is Digital Image Plethysmographic (DIP) Acquisition a Valid New Tool for Preoperative Body Composition Assessment? A Validation by Dual-energy X-ray Absorptiometry

“…23 Gastric banding procedures induce considerable weight loss in obese subjects. 24,25 Gastric bypass, the most frequent operation performed in USA, is more invasive and still more efficient, with satisfactory >60% EWL. 2,26 Biliopancreatic diversion of Scopinaro et al 27,28 is a mixed and complex operation that, in association with nutrient supplementation to avoid nutritional deficiency, has shown the most effectiveness in weight loss and permanent normalization of serum glucose, triglyceride, and cholesterol levels, with results maintained for >10 years follow-up.…”

De la chirurgie bariatrique à la chirurgie métabolique : vers un nouveau paradigme dans le traitement du diabète de type 2

“…Ainsi, dans notre série de 658 patients publiée en 1998, 8,5 % des patients avaient bénéficié de cette intervention alors qu'ils n'atteignaient pas ce seuil critique d'IMC, avec néanmoins une amélioration des divers marqueurs du syndrome métabolique, y compris la glycémie à jeun [15]. Depuis lors, au moins trois publications ont fait état de résul-tats positifs obtenus avec le cerclage gastrique ajustable chez des patients DT2 avec un IMC < 35 kg/ m² [16][17][18] (tableau I). Dans un travail comparant le cerclage ajustable à un traitement médical conventionnel chez des patients DT2 avec un IMC entre 30 et 40 kg/m² (moyenne : 37,1 kg/m²), seulement 13 des 60 patients inclus avaient un IMC < 35 kg/m², ce qui n'est guère représentatif [19].…”