Laparoscopic adjustable gastric banding with truncal vagotomy versus laparoscopic adjustable gastric banding alone: interim results of a prospective randomized trial

Angrisani, Luigi; Cutolo, Pier Paolo; Ciciriello, Melania Battaglini; Vitolo, Giuliana; Persico, Francesco; Lorenzo, Michele; Scarano, P

doi:10.1016/j.soard.2008.08.024

Cited by 27 publications

(17 citation statements)

References 10 publications

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“…Angrisani et al [9] found no significant difference in weight loss between 25 patients undergoing LAGB with truncal vagotomy and those who had LAGB in a prospective study. Their interim results mirror our intermediate report on 41 of 49 severely obese patients undergoing truncal vagotomy at the time of laparoscopic adjustable gastric banding, which shows no statistical significance in %EWL.…”

Section: Discussionmentioning

confidence: 91%

Laparoscopic adjustable gastric banding with truncal vagotomy: any increased weight loss?

Martin

Earle

2011

Surg Endosc

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Section: Discussionmentioning

confidence: 91%

Laparoscopic adjustable gastric banding with truncal vagotomy: any increased weight loss?

Martin

Earle

2011

Surg Endosc

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“…The role of vagotomy in obesity treatment was first examined by Kral (38) in 1978 showing important weight loss among 3 women after vagotomy without serious side effects. However, most do not believe that there is an additional weight loss effect of vagotomy when combined with modern bariatric procedures, as shown with LAGB in a recent trial (39). Furthermore, there are only 2 cases reporting vagotomy in craniopharyngioma patients, both combined with a RYGB (27,40).…”

Section: Discussionmentioning

confidence: 99%

Bariatric Surgery Following Treatment for Craniopharyngioma: A Systematic Review and Individual-Level Data Meta-Analysis

Bretault

Boillot

Muzard

et al. 2013

The Journal of Clinical Endocrinology &Amp; Metabolism

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Objectives: Craniopharyngiomas are rare low-grade tumors located in the hypothalamic and/or pituitary region. Hypothalamic involvement and treatment resulting in hypothalamic damage are known to lead to development of "hypothalamic obesity" (HyOb) in 50% of cases. The management of HyOb, associated with eating disorders and rapid comorbidities, is an important issue. Bariatric surgery is the most effective therapy for weight loss in patients with severe exogenous obesity. The aim of this systematic review and meta-analysis was to determine the 12-month outcome of bariatric surgery for HyOb due to craniopharyngioma treatment. Methods and Results:Relevant studies were identified by searches of the MEDLINE and EMBASE databases until January 2013. A total of 21 cases were included: 6 with adjustable gastric banding, 8 with sleeve gastrectomy, 6 with Roux-en-Y gastric bypass, and 1 with biliopancreatic diversion. After data pooling, mean weight difference was Ϫ20.9 kg after 6 months (95% confidence interval [CI], Ϫ35.4, Ϫ6.3) and Ϫ15.1 kg after 12 months (95% CI, Ϫ31.7, ϩ1.4). The maximal mean weight loss was achieved by the gastric bypass group: Ϫ31.0 kg (95% CI, Ϫ77.5, ϩ15.5) and Ϫ33.7 kg (95% CI, Ϫ80.7, ϩ13.3) after 6 and 12 months, respectively. Conclusions:In this largest ever published study on the effect of bariatric surgery on obesity after craniopharyngioma treatment, we observed an important weight loss after 1 year of follow-up. Larger studies are warranted to establish appropriate selection criteria and the best surgical technique to perform bariatric surgery. (J Clin Endocrinol Metab 98: 2239 -2246, 2013) C raniopharyngiomas are benign, slow-growing tumors that are located within the sellar and parasellar region of the central nervous system. There are 2 histological types: the adamantinomatous tumors, mostly seen in children, which arise from epithelial remnants of the Rathke's pouch; and the squamous papillary form, seen in adults. The incidence rate ranges from 0.5 to 2 per million subjects/year, with a peak between 5 and 14 years of age, although craniopharyngiomas can occur at any age (1).Tumor resection, with or without radiotherapy, represents the therapeutic standard of care. After treatment, obesity and eating disorders are observed in 40 -50% of patients (2-4). Weight gain is also observed at diagnosis before treatment in some patients. Risk factors for the development of obesity after treatment of craniopharyngioma include younger age at diagnosis, presence of endocrinopathy whatever type, initial symptoms of intracranial hypertension, greater body mass index (BMI) at diagnosis, familial predisposition for obesity, and hypothalamic involvement. In addition, pterional surgery, multiple surgery, and hypothalamic irradiation with doses greater than 51 Gy have been associated with the development of obesity (3,(5)(6)(7).The cause of weight gain in this setting is incompletely understood, but it is believed to be due to "endogenous" mechanisms, rather than the more common form of "exogenous" obesit...

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“…Vagotomy has been shown to block ghrelin's effects on food intake, 166 so it is possible that sectioning the branch of vagus nerve that innervates stomach fundus during bariatric procedures results in weight loss via a lack of ghrelin action. To test the hypothesis that vagal denervation might result in additional weight loss, Angrisani and colleagues 167 performed LAGS with and without truncal vagotomy. At 12 or 18 months postsurgery, there was no difference in BMI and EWL between the two groups.…”

Section: Vagus Nervementioning

confidence: 99%

Mechanisms Responsible for Excess Weight Loss after Bariatric Surgery

Ionut

Bergman

2011

J Diabetes Sci Technol

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Obesity has increased alarmingly in the United States and is increasing in many countries of the world. Because obesity is an important risk factor for type 2 diabetes and other chronic diseases, it is important to develop approaches to counter the rapid increase in adiposity. One approach is bariatric surgery, the most successful clinical intervention known for treating obesity. Surgery can result in impressive weight loss and improvement of obesity-related comorbidities. Yet the mechanisms responsible for this remarkable effect of surgery remain controversial. It is now clear that caloric restriction, per se, does not explain all the reduction in stored fat mass after surgery. A number of gastrointestinal hormones, including glucagon-like peptide (GLP)-1, peptide YY, oxyntomodulin, GLP-2, glucose-dependent insulinotropic polypeptide, ghrelin, and others, can play roles in energy homeostasis and could be involved in bariatric-surgery-related weight loss and weight loss maintenance. Vagal innervation may play a role. In addition, there may be other yet-uncharacterized factors that could participate. This review discusses the possible roles of these hormonal mechanisms in various types of bariatric surgery to help elucidate some of the potential mechanisms at play in short-term and long-term post-bariatric surgery weight loss. Understanding such mechanisms could lead to new and efficacious means to control or even reduce the epidemic of obesity.

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Laparoscopic adjustable gastric banding with truncal vagotomy versus laparoscopic adjustable gastric banding alone: interim results of a prospective randomized trial

Cited by 27 publications

References 10 publications

Laparoscopic adjustable gastric banding with truncal vagotomy: any increased weight loss?

Laparoscopic adjustable gastric banding with truncal vagotomy: any increased weight loss?

Bariatric Surgery Following Treatment for Craniopharyngioma: A Systematic Review and Individual-Level Data Meta-Analysis

Mechanisms Responsible for Excess Weight Loss after Bariatric Surgery

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