Meta-analysis of the effectiveness of laparoscopic adjustable gastric banding versus laparoscopic sleeve gastrectomy for obesity

Li, Laiyuan; Yu, Huichuan; Liang, Jingtao; Guo, Yinyin; Peng, Shaoyong; Luo, Yanxin; Wang, Jianping

doi:10.1097/md.0000000000014735

Cited by 15 publications

(13 citation statements)

References 60 publications

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“…Similar findings were reported by Steffen et al in a 7-year prospective study on 388 patients undergoing LAGB [11]. In a metanalysis by Li et al, rates of hypertension improvement were similar to those seen after laparoscopic sleeve gastrectomy (61% versus 63%) [12]. In contrast, Aarts et al, after analyzing data from 201 patients followed up for 14 years, noticed that comorbidities returned or patients developed new ones, despite initially observed improvement [13].…”

Section: Discussionsupporting

confidence: 79%

Laparoscopic Adjustable Gastric Banding—Should a Second Chance Be Given?

et al. 2020

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Background Obesity is a chronic relapsing-remitting disease and a global pandemic, being associated with multiple comorbidities. Laparoscopic adjustable gastric banding (LAGB) is one of the safest surgical procedures used for the treatment of obesity, and even though its popularity has been decreasing over time, it still remains an option for a certain group of patients, producing considerable weight loss and improvement in obesity-associated comorbidities. Methods The aim of this study was to evaluate the impact of weight loss following LAGB on obesity-associated comorbidities, and to identify factors that could predict better response to surgery, and patient sub-groups exhibiting greatest benefit. A total of 99 severely obese patients (81.2% women, mean age 44.19 ± 10.94 years, mean body mass index (BMI) 51.84 ± 8.77 kg/m2) underwent LAGB in a single institution. Results obtained 1, 2, and 5 years postoperatively were compared with the pre-operative values using SPPS software version 20. Results A significant drop in BMI was recorded throughout the follow-up period, as well as in A1c and triglycerides, with greatest improvement seen 2 years after surgery (51.8 ± 8.7 kg/m2 vs 42.3 ± 9.2 kg/m2, p < 0.05, 55.5 ± 19.1 mmol/mol vs 45.8 ± 13.7 mmol/mol, p < 0.05, and 2.2 ± 1.7 mmol/l vs 1.5 ± 0.6 mmol/l). Better outcomes were seen in younger patients, with lower duration of diabetes before surgery, and lower pre-operative systolic blood pressure. Conclusions Younger age, lower degree of obesity, and lower severity of comorbidities at the time of surgery can be important predictors of successful weight loss, making this group of patients the ideal candidates for LAGB.

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Section: Discussionsupporting

confidence: 79%

Laparoscopic Adjustable Gastric Banding—Should a Second Chance Be Given?

et al. 2020

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“…Bariatric procedures are considered the most effective long-term obesity treatment in elderly patients [2,3]. Weight loss subsequent to bariatric surgery causes sustainable improvement or remission of hypertension and type 2 diabetes mellitus in severely obese patients [4–6]. However, controversy exists with regard to the effectiveness and reasons for bariatric surgery in elderly patients [7–9].…”

Section: Introductionmentioning

confidence: 99%

A Retrospective Study of 6-Month Reduction in Risk of Developing Cardiovascular Diseases and Type 2 Diabetes Mellitus in Severely Obese Patients Over 60 Years of Age Following Bariatric Surgery

et al. 2019

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Background Controversy exists with regard to the effectiveness and reasons for bariatric procedures in patients older than 60 years. The goal of our study was to determine the reduction in risk of developing cardiovascular disease and type 2 diabetes mellitus after undergoing bariatric surgery in obese patients over age 60 at our institution. Material/Methods Patients with severe obesity (BMI >40 kg/m 2 ) were retrospectively included in the study. Risk of cardiovascular disease and type 2 diabetes at baseline and their reduction during the follow-up period were evaluated with the following selected, currently preferred risk algorithms: (1) the Systemic Coronary Risk Evaluation (SCORE) scale; (2) the Framingham Risk Score (of myocardial infarction or coronary death) for patients with no prior history of diabetes, coronary heart disease, or intermittent claudication; and (3) the Framingham Offspring Diabetes Risk Score, which estimates the 8-year risk of developing type 2 diabetes. Results All 33 elderly patients (32 women and 1 man, mean age 62.3±2.7 (BMI 44.3±6.2 kg/m 2 ) significantly reduced their risk levels. We observed a decrease in the 10-year risk of a first fatal cardiovascular event (3.5±0.5 vs. 2.4±0.5, absolute risk reduction [ARR] 1.0); reduced 10-year risk of myocardial infarction or death (5.0±1.6 vs. 3.25±1.6, ARR 1.7); and reduced predicted 8-year risk of developing type 2 diabetes (7.4±7.2 vs. 3.1±0.3, ARR 4.3). No intra- or postoperative complications were observed. Conclusions Our study showed a significant reduction in risk of developing cardiovascular diseases and type 2 diabetes, as measured by available risk scores, in elderly patients undergoing bariatric procedures.

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“…LSG and LRYGB were studied in comparison to the LAGB and found to be superior. LSG and LRYGB showed greater weight loss with improvement or remission of comorbidities compared with LAGB [18][19][20][21]. Tice et al showed superior %EWL (76% vs. 48%) and diabetes resolution (78% vs. 50%) comparing LRYGB and LAGB.…”

Section: Discussionmentioning

confidence: 99%

Reoperations for Long-Term Complications Following Laparoscopic Adjustable Gastric Banding: Analysis of Incidence and Causality

Mellert

Cheung

Berbiglia³

et al. 2020

Cureus

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Background: Laparoscopic adjustable gastric banding (LAGB) gained popularity in the early 2000s as a purely restrictive procedure with modest weight loss. The potential for complications requiring reoperation has since become evident. A retrospective review was performed to determine the incidence of long-term complications and predictive factors requiring surgical reintervention after LAGB. Methods: Institutional review board approval was obtained, and a retrospective review of 200 consecutive patients undergoing LAGB over a period of six years was conducted at a single institution with American Society of Metabolic and Bariatric Surgery Center of Excellence designation. Data were collected on patient characteristics, comorbid conditions and complications requiring reintervention. Statistical analysis was performed using SPSS Statistics software (IBM Corp., Armonk, NY). Results: Of the 200 patients, 176 (90.7%) were female with an average age of 53.6 years and preoperative body mass index (BMI) of 44.2 kg/m 2. The average follow-up was 46 months. Complications occurred in 55 (28.4%) patients with band slippage/prolapse as the most common need for reoperation. Younger age, lack of comorbidities and diet/exercise compliance were associated with reintervention. Conclusions: LAGB has a high rate of reoperation secondary to complications associated with younger age. Alternative bariatric procedures may be more appropriate in these patients who have fewer comorbid conditions and are motivated to improve his or her health.

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Meta-analysis of the effectiveness of laparoscopic adjustable gastric banding versus laparoscopic sleeve gastrectomy for obesity

Abstract: Supplemental Digital Content is available in the text

Cited by 15 publications

References 60 publications

Laparoscopic Adjustable Gastric Banding—Should a Second Chance Be Given?

Laparoscopic Adjustable Gastric Banding—Should a Second Chance Be Given?

A Retrospective Study of 6-Month Reduction in Risk of Developing Cardiovascular Diseases and Type 2 Diabetes Mellitus in Severely Obese Patients Over 60 Years of Age Following Bariatric Surgery

Reoperations for Long-Term Complications Following Laparoscopic Adjustable Gastric Banding: Analysis of Incidence and Causality

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