Long-term outcomes and frequency of reoperative bariatric surgery beyond 15 years after gastric banding: a high band failure rate with safe revisions

Tsai, Catherine; Zehetner, Jörg; Beel, Julia; Steffen, Rudolf

doi:10.1016/j.soard.2019.03.017

Cited by 17 publications

(8 citation statements)

References 29 publications

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“…LSG and RYGB have been proposed as effective revisional procedures after failed LAGB. Both show good shortterm outcomes and acceptable postoperative complication rates [1][2][3][4][5][6]. It is controversial which of the two procedures is more effective on long-term (> 5 years) weight loss, comorbidities control, and complications [3,6].…”

Section: Discussionmentioning

confidence: 99%

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Long-term outcomes of sleeve gastrectomy as a revisional procedure after failed gastric band: a multicenter cross-matched cohort study

Angelis¹,

Boru²,

Iossa³

et al. 2021

Updates Surg

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Laparoscopic adjustable gastric band (LAGB) is the bariatric procedure most likely subject to revisional surgery. Both laparoscopic sleeve gastrectomy (LSG) and Roux-en-Y gastric bypass (LRYGB) represent viable options, but the long-term results are still lacking. In 2014, we published the 2-year follow-up of our multicenter cohort of revisional LSG after failed LAGB. Evaluate the long-term follow-up (median 9.3 years) of the same cohort of patients. University and primary-care hospitals, Italy. We retrospectively examined a prospectively maintained database of the previously published multicenter cohort of 56 patients who underwent LSG after failed LAGB between 2008–2011. The control group included cross-matched non-revisional LSGs. The primary endpoint was weight loss, secondary endpoints co-morbidities, and the need for further bariatric surgery. The study group included 44 patients and the control group 56. We found %EWL 53% Vs. 67% (p = .021), %EBMIL (54 Vs. 68%, p = .018), %TWL (26 Vs. 34%, p = .002). We also found more severe GERD (gastroesophageal reflux disease) symptoms in the revisional than in the primary group (9.0 vs. 1.8% mild and 23.0 vs. 3.0% severe). Ten patients from the revisional group (22.7%) vs. eight in the primary group (13%) underwent further bariatric surgery (LRYGB). Our results showed less favorable weight loss in revisional than primary LSG after LABG, higher prevalence of GERD, and a more frequent need for further revisional surgery. Despite the study’s limitations, the present data suggest that the long-term outcomes may offset the possible reduced short-term complication rate after revisional sleeve gastrectomy for a failed LABG.

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Section: Discussionmentioning

confidence: 99%

“…Laparoscopic adjustable gastric band (LAGB) is the bariatric procedure most likely subject to revisional surgery [ 1 ]. Despite good short-term outcomes in weight loss and postoperative complications, it is associated with over 50% long-term failure [ 1 , 2 ].…”

Section: Introductionmentioning

confidence: 99%

Long-term outcomes of sleeve gastrectomy as a revisional procedure after failed gastric band: a multicenter cross-matched cohort study

Angelis¹,

Boru²,

Iossa³

et al. 2021

Updates Surg

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“…Some studies, however, reported that AGB failed to maintain reduced body weight or control obesity-related morbidities ( Pournaras et al, 2010 ; Chang et al, 2014 ; Park et al, 2019 ). Worse still, additional studies showed that patients who underwent AGB may need a second surgery due to band migration or erosion, pouch dilatation, achalasia or megaesophagus, stomach obstruction, or other severe complications ( Arias et al, 2009 ; Chang et al, 2014 ; Kodner and Hartman, 2014 ; Tsai et al, 2019 ). The reported reoperation rate was up to 82.7% in 15-year follow-up ( Tsai et al, 2019 ).…”

Section: Introductionmentioning

confidence: 99%

“…Worse still, additional studies showed that patients who underwent AGB may need a second surgery due to band migration or erosion, pouch dilatation, achalasia or megaesophagus, stomach obstruction, or other severe complications ( Arias et al, 2009 ; Chang et al, 2014 ; Kodner and Hartman, 2014 ; Tsai et al, 2019 ). The reported reoperation rate was up to 82.7% in 15-year follow-up ( Tsai et al, 2019 ). As a result, the popularity of AGB has been dramatically decreased in the past decade.…”

Section: Introductionmentioning

confidence: 99%

Efficacy and Mechanisms of Gastric Volume-Restriction Bariatric Devices

Wang

Kassab

2021

Front. Physiol.

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Obesity is a chronic disease that affects over 795 million people worldwide. Bariatric surgery is an effective therapy to combat the epidemic of clinically severe obesity, but it is only performed in a very small proportion of patients because of the limited surgical indications, the irreversibility of the procedure, and the potential postoperative complications. As an alternative to bariatric surgery, numerous medical devices have been developed for the treatment of morbid obesity and obesity-related disorders. Most devices target restriction of the stomach, but the mechanism of action is likely more than just mechanical restriction. The objective of this review is to integrate the underlying mechanisms of gastric restrictive bariatric devices in obesity and comorbidities. We call attention to the need for future studies on potential mechanisms to shed light on how current gastric volume-restriction bariatric devices function and how future devices and treatments can be further improved to combat the epidemic of obesity.

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“…Long-term weight regain (WR) determining the frequent occurrence of revisional surgery and the not negligible postoperative complications (i.e., slippage, migration, erosion) remain some of the major concerns about LAGB. Therefore, the bariatric community progressively reduced and abandoned this technique [5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

It is really time to retire laparoscopic gastric banding? Positive outcomes after long-term follow-up: the management is the key

Lucido

Scognamiglio²,

Nesta

et al. 2021

Updates Surg

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After the initial widespread diffusion, laparoscopic adjustable gastric banding (LAGB) has been progressively abandoned and laparoscopic sleeve gastrectomy (LSG) has become the worldwide most adopted procedure. Nevertheless, recent reports raised concerns about the long-term weight regain after different bariatric techniques. Considering the large LAGB series recorded in our multicentric bariatric database, we analysed the anthropometric and surgical outcomes of obese patients underwent LAGB at a long-term follow-up, focusing on LAGB management. Between January 2008 to January 2018, demographics, anthropometric and post-operative data of obese patients undergone LAGB were retrospectively evaluated. To compare the postoperative outcomes, the cohort was divided in two groups according to the quantity of band filling (QBF): low band filling group (Group 1) with at most 3 ml of QBF, and patients in the high band filling group (Group 2) with at least 4 ml. 699 obese patients were considered in the analysis (351 in Group 1 and 348 in Group 2). Patients in Group 1 resulted significantly associated (p < 0.05) to higher % EWL and quality of life score (BAROS Score), 49.1 ± 11.3 vs 38.2 ± 14.2 and 5.9 ± 1.8 vs 3.8 ± 2.5, respectively. Moreover, patients with lower band filling (Group 1) complained less episodes of vomiting, epigastric pain and post-prandial reflux and significantly decreased slippage and migration rate (p < 0.001 for all parameters). LAGB is a safe and reversible procedure, whose efficacy is primarily related to correct postoperative handling. Low band filling and strict follow-up seem the success’ key of this technique, which deserves full consideration among bariatric procedures.

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Long-term outcomes and frequency of reoperative bariatric surgery beyond 15 years after gastric banding: a high band failure rate with safe revisions

Cited by 17 publications

References 29 publications

Long-term outcomes of sleeve gastrectomy as a revisional procedure after failed gastric band: a multicenter cross-matched cohort study

Long-term outcomes of sleeve gastrectomy as a revisional procedure after failed gastric band: a multicenter cross-matched cohort study

Efficacy and Mechanisms of Gastric Volume-Restriction Bariatric Devices

It is really time to retire laparoscopic gastric banding? Positive outcomes after long-term follow-up: the management is the key

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