Long-term results, late complications and quality of life in a series of adjustable gastric banding

Adjustable gastric banding is currently the most common bariatric operation. This study is a retrospective analysis of the Finnish experience with this procedure over the last 10 years. Between March 1993 and June 1999, 123 patients underwent either open (36) or laparoscopic (87) surgery for morbid...

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Bibliographic Details
Published in:Obesity surgery 2004-05, Vol.14 (5), p.648-654
Main Authors: Martikainen, Tarja, Pirinen, Elina, Alhava, Esko, Poikolainen, Eero, Pääkkönen, Matti, Uusitupa, Matti, Gylling, Helena
Format: Article
Language:English
Subjects:
Adult
Aged
Comorbidity
Female
Gastroplasty - adverse effects
Humans
Male
Middle Aged
Obesity
Obesity, Morbid - epidemiology
Obesity, Morbid - surgery
Postoperative Complications
Quality of Life
Reoperation
Retrospective Studies
Treatment Outcome
Weight Loss
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Summary:Adjustable gastric banding is currently the most common bariatric operation. This study is a retrospective analysis of the Finnish experience with this procedure over the last 10 years. Between March 1993 and June 1999, 123 patients underwent either open (36) or laparoscopic (87) surgery for morbid obesity by the application of an adjustable gastric band. Data on preoperative clinical characteristics and postoperative outcome and weight-loss patterns up to 9 years (mean 55 months) are presented and also evaluated by the Bariatric Analysis and Reporting Outcome System (BAROS). Sex ratio was 31% males / 69% females, mean age 44 years and mean +/- SD preoperative BMI 49 +/- 8 kg/m(2) (range 33.6-85.1). During the evaluation period (March 1993 December 2002), 54% of patients experienced postoperative complications requiring hospital treatment >or= 7 days, and 52% underwent a reoperation. 33% of bands were removed. The most important late complications were esophagitis (30%), obstruction due to slippage / pouch dilatation (21%), incisional hernia (9%) and band erosion (9%). Mean excess weight loss at 1 and 2 year follow-up was 36% and 38%, which later stabilized to 30%. During the evaluation period, there were 10 deaths, 2 of which were 30-day deaths, and the remainder were not associated with the band. According to BAROS, the outcome was regarded as "very good" in 3%, "good" in 7%, "fair" in 40% and "failure" in 50%. Our long-term data found that weight reduction is acceptable,but the incidence of late complications and reoperations was high.
ISSN:0960-8923
1708-0428
DOI:10.1381/096089204323093435