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Musella M, Berardi G, Velotti N, Schiavone V, Vitiello A. Ten-Year Results of Laparoscopic Sleeve Gastrectomy: Retrospective Matched Comparison with Laparoscopic Adjustable Gastric Banding-Is There a Significant Difference in Long Term? Obes Surg 2021; 31:5267-5274. [PMID: 34601648 PMCID: PMC8595233 DOI: 10.1007/s11695-021-05735-w] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 09/15/2021] [Accepted: 09/22/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND The laparoscopic sleeve gastrectomy (LSG) is the most common bariatric procedure performed worldwide while the laparoscopic adjustable gastric banding (LAGB) has been almost abandoned. Aim of this study was to retrospectively assess 10-year outcomes of LSG through a matched comparison with LAGB. MATERIALS AND METHODS Retrospective search of prospectively maintained database of our university was carried out to find all patients that underwent LSG before December 2010. Each subject with LSG was matched one-to-one with a patient that had undergone LAGB in the same period with correspondent preoperative age, BMI, and sex. RESULTS A total of 76 patients underwent LSG before 2010 and were all included in this study; a matched group of 76 out of 178 LAGB patients with 10-year follow-up was retrieved from our database. Comparison between the two groups showed better outcomes after LSG at 1 and 5 years but weight loss was comparable with the LAGB group at 10 years (%TWL 22.2 ± 13 vs 21.2 ± 16.1; p = 0.89). No significant difference was found in conversion/removal rate (15.8% vs 18.4%; p = 0.67). CONCLUSION LSG is an effective stand-alone bariatric procedure with better outcomes than LAGB in medium term, but results are comparable at 10 years. Subjects undergoing LSG should be informed that conversion to RYGB or OAGB may be necessary to achieve further weight loss or to treat reflux.
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Affiliation(s)
- Mario Musella
- Advanced Biomedical Sciences Department, Naples “Federico II” University, AOU “Federico II”, Via S. Pansini 5, 80131 Naples, Italy
| | - Giovanna Berardi
- Advanced Biomedical Sciences Department, Naples “Federico II” University, AOU “Federico II”, Via S. Pansini 5, 80131 Naples, Italy
| | - Nunzio Velotti
- Advanced Biomedical Sciences Department, Naples “Federico II” University, AOU “Federico II”, Via S. Pansini 5, 80131 Naples, Italy
| | - Vincenzo Schiavone
- Advanced Biomedical Sciences Department, Naples “Federico II” University, AOU “Federico II”, Via S. Pansini 5, 80131 Naples, Italy
| | - Antonio Vitiello
- Advanced Biomedical Sciences Department, Naples “Federico II” University, AOU “Federico II”, Via S. Pansini 5, 80131 Naples, Italy
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Vadalà di Prampero SF, Bulajic M, Giustacchini P, Manzoni G, Costamagna G. Endoscopic revision for weight regain after open vertical-banded gastroplasty. VIDEOGIE : AN OFFICIAL VIDEO JOURNAL OF THE AMERICAN SOCIETY FOR GASTROINTESTINAL ENDOSCOPY 2021; 6:404-406. [PMID: 34527837 PMCID: PMC8430376 DOI: 10.1016/j.vgie.2021.05.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Video 1Technical feasibility, safety, and efficacy of a novel endoscopic approach to treating weight regain after open vertical-banded gastroplasty using an endoscopic suturing device.
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Affiliation(s)
- Salvatore F Vadalà di Prampero
- Gastroenterology and GI Endoscopy Unit, Mater Olbia Hospital, Qatar Foundation Endowment & Gemelli Foundation, Olbia, Italy
| | - Milutin Bulajic
- Gastroenterology and GI Endoscopy Unit, Mater Olbia Hospital, Qatar Foundation Endowment & Gemelli Foundation, Olbia, Italy
| | - Piero Giustacchini
- Endocrine and Metabolic Surgery Unit, Mater Olbia Hospital, Qatar Foundation Endowment & Gemelli Foundation, Olbia, Italy
- Division of Endocrine and Metabolic Surgery, Fondazione Policlinico A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Gabriella Manzoni
- Department of Radiology, Mater Olbia Hospital, Qatar Foundation Endowment & Gemelli Foundation, Olbia, Italy
| | - Guido Costamagna
- Digestive Endoscopy Unit, Università Cattolica del Sacro Cuore, Rome, Italy
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3
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Denneval A, Chalumeau C, Iceta S, Pelascini E, Disse E, Robert M. Revision of Mason's procedure (vertical banded gastroplasty) to Roux-en-Y gastric bypass: role of an associated fundectomy in weight loss outcomes. Surg Obes Relat Dis 2021; 17:870-877. [PMID: 33549506 DOI: 10.1016/j.soard.2020.12.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 12/21/2020] [Accepted: 12/30/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND Vertical banded gastroplasty (VBG) presents a significant rate of long-term complications, and revisions are often necessary. Conversion to Roux-en-Y gastric bypass (RYGB) seems to be preferred, but literature data remain limited. OBJECTIVES To analyze the indications, safety, results of conversions from VBG to RYGB, and to identify predictive factors of success or failure. SETTING Two specialized centers of bariatric surgery. METHODS This bicentric retrospective study included all the patients who benefited from a conversion from VBG to RYGB between 2008 and January 2020. Demographic characteristics, indications, preoperative workups, intraoperative data, complications, and weight loss results were analyzed. RESULTS During the study period, 85 patients underwent a conversion to RYGB. The mean body mass index (BMI_ before conversion was 40.6 kg/m2. 82.3% of the patients were converted because of weight loss failure and 17.6% because of a complication of their VBG. The global rate of complications was 25%. After an average follow-up of 35 months and a rate of loss to follow-up of 33%, the mean BMI was 33.5 kg/m. The weight loss success rate according to Reinhold's criteria was 64.7%, and resolution of complications was obtained in 89.1%. The association of a fundectomy was a predictive factor of weight loss (odds ratio, .27; P = .04), whereas primary failure of the VBG was a predictive factor of failure. CONCLUSION Conversion from VBG to RYGB remains the procedure of choice to achieve satisfying weight loss and resolution of functional complications. The addition of a fundectomy appeared to have a significant positive impact on weight loss outcomes.
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Affiliation(s)
- Axel Denneval
- Department of Digestive Surgery, Center of Bariatric Surgery, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France; Department of Endocrinology Diabetology and Nutrition, Centre Intégré et Spécialisé de l'Obésité de Lyon, Groupement Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre Bénite, France.
| | - Claire Chalumeau
- Fédération de Chirurgie Viscérale, Centre Hospitalier William Morey, Chalon-sur-Saône, France
| | - Sylvain Iceta
- Department of Endocrinology Diabetology and Nutrition, Centre Intégré et Spécialisé de l'Obésité de Lyon, Groupement Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre Bénite, France; Université Claude Bernard Lyon 1, Lyon, France; Quebec Heart and Lung Institute (IUCPQ), Québec, Canada; School of Nutrition, Laval University, Québec, Canada
| | - Elise Pelascini
- Department of Digestive Surgery, Center of Bariatric Surgery, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France; Department of Endocrinology Diabetology and Nutrition, Centre Intégré et Spécialisé de l'Obésité de Lyon, Groupement Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre Bénite, France
| | - Emmanuel Disse
- Department of Endocrinology Diabetology and Nutrition, Centre Intégré et Spécialisé de l'Obésité de Lyon, Groupement Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre Bénite, France; Université Claude Bernard Lyon 1, Lyon, France; Carmen Lab, INSERM Unit 1060, Groupement Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre Bénite, France
| | - Maud Robert
- Department of Digestive Surgery, Center of Bariatric Surgery, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France; Department of Endocrinology Diabetology and Nutrition, Centre Intégré et Spécialisé de l'Obésité de Lyon, Groupement Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre Bénite, France; Université Claude Bernard Lyon 1, Lyon, France; Carmen Lab, INSERM Unit 1060, Groupement Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre Bénite, France
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4
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Greilsamer T, Jacobi D, Krempf M, Boulanger G, Guillouche M, Cariou B, Mirallié E, Blanchard C. Long-Term Complications of Open Mason's Vertical Banded Gastroplasty at a Single Tertiary Center and Literature Review. Am Surg 2020. [DOI: 10.1177/000313481908501234] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Vertical banded gastroplasty (VBG), introduced by Mason in 1982, is now discarded because of important long-term complications and technical difficulties to do revisional surgery. We investigated the long-term complications of VBG in our center and compared it with the literature data. Patients who underwent an open VBG at the University Hospital of Nantes between October 1991 and May 2006 were included. We reviewed preoperative clinical data, long-term outcome in weight loss, complications, and revisional surgeries with a long follow-up. Sixty-three patients (52 women and 11 men) were included, with a mean age of 43 ± 10 years and a body mass index of 46.7 ± 8.3 kg/m. The mean follow-up was 8.2 ± 4.2 years. At the end of follow-up, the mean excess weight loss (EWL) was 29.8%. Long-term success (excess weight loss > 50%) of the procedure was observed in 25 patients (39.7%). A second intervention was performed in 15 patients (23.8%), and three needed a third redo procedure. Six patients (40%) had this new intervention for late complications, and nine (60%) for weight regain. Weight loss is satisfying in the long term although the rate of reintervention is high. Long-term complication can be severe, especially with gastric stenosis that could lead to esophageal cancer. A second reintervention could be technically demanding, especially by laparoscopy, and the patients should be referred to a specialized center.
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Affiliation(s)
- Tristan Greilsamer
- Clinique de Chirurgie Digestive et Endocrinienne (CCDE), Institut des Maladies de L'Appareil Digestif (IMAD), Centre Hospitalier Universitaire (CHU) Nantes-Hôtel Dieu, Nantes, France
| | - David Jacobi
- Department of Endocrinology, CHU de Nantes, Nantes, France; and
- L'institut du thorax, INSERM, CNRS, Université de Nantes, Nantes, France
| | - Michel Krempf
- Department of Endocrinology, CHU de Nantes, Nantes, France; and
- L'institut du thorax, INSERM, CNRS, Université de Nantes, Nantes, France
| | - Guillaume Boulanger
- Clinique de Chirurgie Digestive et Endocrinienne (CCDE), Institut des Maladies de L'Appareil Digestif (IMAD), Centre Hospitalier Universitaire (CHU) Nantes-Hôtel Dieu, Nantes, France
| | | | - Bertrand Cariou
- Department of Endocrinology, CHU de Nantes, Nantes, France; and
- L'institut du thorax, INSERM, CNRS, Université de Nantes, Nantes, France
| | - Eric Mirallié
- Clinique de Chirurgie Digestive et Endocrinienne (CCDE), Institut des Maladies de L'Appareil Digestif (IMAD), Centre Hospitalier Universitaire (CHU) Nantes-Hôtel Dieu, Nantes, France
| | - Claire Blanchard
- Clinique de Chirurgie Digestive et Endocrinienne (CCDE), Institut des Maladies de L'Appareil Digestif (IMAD), Centre Hospitalier Universitaire (CHU) Nantes-Hôtel Dieu, Nantes, France
- L'institut du thorax, INSERM, CNRS, Université de Nantes, Nantes, France
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Khewater T, Yercovich N, Grymonprez E, Horevoets J, Mulier JP, Dillemans B. Twelve-Year Experience with Roux-en-Y Gastric Bypass as a Conversional Procedure for Vertical Banded Gastroplasty: Are We on the Right Track? Obes Surg 2020; 29:3527-3535. [PMID: 31187456 DOI: 10.1007/s11695-019-04002-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Vertical banded gastroplasty (VBG) has high rates of long-term complications. Conversion to Roux-en-Y gastric bypass (RYGB) is considered optimal; however, there are limited data on the late results of these conversions. We aimed to analyze our single-center long-term outcomes of patients requiring conversional RYGB for a failed VBG. METHODS The records of patients who underwent RYGB as a conversional procedure after VBG from November 2004 to December 2016 were reviewed. Follow-up data were obtained by direct telephone calls with patients, electronic files, and general practitioner reports. Characteristics, indications of conversion, long-term (> 30 days) morbidities, weight records, obesity-related comorbidities, and overall patient satisfaction were analyzed. RESULTS Overall, 305 VBG patients (82% female) underwent conversional RYGB during the study period. The mean pre-RYGB body mass index (BMI) was 35.6 (23-66) kg/m2. Conversions were indicated in 61% of patients because of simultaneous VBG complications and weight regain. After a median follow-up of 74.3 (5-151) months, 225 (73.8%) patients agreed to participate. The mean BMI and percentage of total weight loss (%TWL) were 28.6 (18-45) kg/m2 and 17.4%, respectively. Nearly all conversion indications were addressed effectively. Surgical reintervention was mandatory in 28 of 225 patients (12.4%) due to complications. Approximately 85% of patients reported complete remission of obesity-related comorbidities, and four-fifths were fully satisfied. CONCLUSION RYGB resolves VBG complications, improves quality of life, and results in prolonged stable weight loss. It has a key role in the management of obesity-related comorbidities and in expert hands is the preferred conversional procedure for patients with failed VBG.
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Affiliation(s)
- Talal Khewater
- Department of Surgery, AZ Sint-Jan Brugge-Oostende AV, Campus Sint-Jan, Ruddershove 10, 8000, Brugge, Belgium.
| | - Nathalie Yercovich
- Department of Surgery, AZ Sint-Jan Brugge-Oostende AV, Campus Sint-Jan, Ruddershove 10, 8000, Brugge, Belgium
| | - Edouard Grymonprez
- Faculty of Medicine, KU Leuven University, Herestraat 49, 3000, Leuven, Belgium
| | - Julie Horevoets
- Department of Surgery, AZ Sint-Jan Brugge-Oostende AV, Campus Sint-Jan, Ruddershove 10, 8000, Brugge, Belgium
| | - Jan Paul Mulier
- Department of Anesthesia, AZ Sint-Jan Brugge-Oostende AV, Campus Sint-Jan, Ruddershove 10, 8000, Brugge, Belgium
| | - Bruno Dillemans
- Department of Surgery, AZ Sint-Jan Brugge-Oostende AV, Campus Sint-Jan, Ruddershove 10, 8000, Brugge, Belgium
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6
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Froylich D, Abramovich TS, Fuchs S, Zippel D, Hazzan D. Long-Term (over 13 Years) Follow-Up of Vertical Band Gastroplasty. Obes Surg 2020; 30:1808-1813. [PMID: 32048151 DOI: 10.1007/s11695-020-04448-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Silastic ring vertical gastroplasty (SRVG) was a popular restrictive procedure 2 and 3 decades ago. However, it was associated with severe complications and a high rate of reoperation due to failure. Examination of long-term outcomes of those patients that underwent SVRG is limited. The aim of our study was to determine the long-term outcomes (over 13 years) of SRVG in our institution and to review the literature of long-term outcomes following SVRG. METHODS Following IRB approval, we reviewed patients who underwent SRVG between 1996 and 2001. Weight loss parameters, preoperative comorbidities, were compared to the follow-up data. RESULTS In total, 92 patients underwent SRVG, and 89 met the inclusion criteria. Mean age was 52.4 ± 10.6 years and body mass index (BMI) was 46.1 ± 6.5 Kg/m2. Preoperative comorbidities rate included diabetes mellitus (19.1%), hypertension (32.5%), hyperlipidemia (21.3%), joints disease (6.7%), mood disorders (7.8%), and dyspeptic disorders (3.3%). Mean length of follow-up was 208.5 ± 16.8 months. Thirty-eight patients (43%) had to be reoperated due to complications and 24 (30%) had an additional bariatric surgery. Follow-up BMI was 34.2 ± 9.8 Kg/m2 (p < 0.001). There was no improvement in any of the comorbidities; incidence of joint disease and dyspeptic disorders were significantly higher at the follow-up (p = 0.03, p < 0.001, respectively). CONCLUSIONS SRVG procedure was associated with high rates of reoperations and revisions. The majority of our patients showed poor resolution of comorbidities and even worsening of some. Our data confirms that SRVG is not suitable as a bariatric procedure.
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Affiliation(s)
- Dvir Froylich
- Department of Surgery B, Carmel Medical Center, 3436212, Haifa, Israel.
| | | | - Steven Fuchs
- Department of Surgery B, Carmel Medical Center, 3436212, Haifa, Israel
| | - Douglas Zippel
- Department of Surgery C, Meirav Breast Health Center, Chaim Sheba Medical Center, Tel Hashomer Hospital, Sackler School of Medicine,Tel-Aviv University, Tel Aviv-Yafo, Israel
| | - David Hazzan
- Department of Surgery B, Carmel Medical Center, 3436212, Haifa, Israel.,Department of Surgery C, Meirav Breast Health Center, Chaim Sheba Medical Center, Tel Hashomer Hospital, Sackler School of Medicine,Tel-Aviv University, Tel Aviv-Yafo, Israel
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7
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van Wezenbeek MR, van Hout GC, Nienhuijs SW. Medical and Psychological Predictors for Long-Term Bariatric Success Using Primary Vertical-Banded Gastroplasty as a Model. Bariatr Surg Pract Patient Care 2016. [DOI: 10.1089/bari.2016.0011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
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8
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van Wezenbeek MR, Smulders FJF, de Zoete JPJGM, Luyer MD, van Montfort G, Nienhuijs SW. Long-term results after revisions of failed primary vertical banded gastroplasty. World J Gastrointest Surg 2016; 8:238-245. [PMID: 27022451 PMCID: PMC4807325 DOI: 10.4240/wjgs.v8.i3.238] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Revised: 11/19/2015] [Accepted: 01/11/2016] [Indexed: 02/07/2023] Open
Abstract
AIM: To compare the results after revision of primary vertical banded gastroplasty (Re-VBG) and conversion to sleeve gastrectomy (cSG) or gastric bypass (cRYGB).
METHODS: In this retrospective single-center study, all patients with a failed VBG who underwent revisional surgery were included. Medical charts were reviewed and additional postal questionnaires were sent to update follow-up. Weight loss, postoperative complications and long-term outcome were assessed.
RESULTS: A total 152 patients were included in this study, of which 21 underwent Re-VBG, 16 underwent cSG and 115 patients underwent cRYGB. Sixteen patients necessitated a second revisional procedure. No patients were lost-to-follow-up. Two patients deceased during the follow-up period, 23 patients did not return the questionnaire. Main reasons for revision were dysphagia/vomiting, weight regain and insufficient weight loss. Excess weight loss (%EWL) after Re-VBG, cSG and cRYGB was, respectively, 45%, 57% and 72%. Eighteen patients (11.8%) reported postoperative complications and 27% reported long-term complaints.
CONCLUSION: In terms of additional weight loss, postoperative complaints and reintervention rate, Roux-en-Y gastric bypass seems feasible as a revision for a failed VBG.
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Abstract
BACKGROUND The vertical banded gastroplasty (VBG) used to be a common restrictive bariatric procedure but has been abandoned by many due to a high failure rate, a high incidence of long-term complications, and the newer adjustable gastric band (AGB) and sleeve. However, potential favorable long-term results and the upcoming banded gastric bypass, with a similar mechanical outlet restriction and control of the pouch size, renewed our interest in the VBG. Therefore, we investigated the long-term outcome of primary VBG at the Catharina Hospital in the Netherlands. METHODS Patients that underwent a primary VBG between 1998 and 2008 were included. Patients' characteristics, operative details, evolution on weight and comorbidities, complications, and outcome of revisions were reviewed. RESULTS A total of 392 patients (80 % female) were reviewed with a mean age of 40 ± 9 years and body mass index of 44 ± 5 kg/m(2). Mean follow-up after VBG was 66 ± 50 months and showed a mean excess weight loss (EWL) of 53 ± 27 % and comorbidity reduction of 54 %. One hundred fifty-two patients (39 %) out of 227 patients (58 %) with long-term complaints underwent revisional surgery. Main reasons for revision were weight regain and vomiting/food intolerance. Analysis before revision showed an outlet dilatation (17 %), pouch dilatation (16 %), and outlet stenosis (10 %). After revision, an additional EWL of 23 % and 33 % further reduction in comorbidities was seen. CONCLUSIONS Primary VBG has an acceptable EWL of 53 % and 55 % of comorbidities were improved. However, the high complication rate, often necessitating revision, underlines the limits of this procedure.
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10
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Bekheit M, Katri K, El-Kayal ES. Gender Influence on Weight Loss After Laparoscopic Sleeve Gastrectomy. Obes Surg 2015; 25:2428-9. [PMID: 26415637 DOI: 10.1007/s11695-015-1894-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- Mohamed Bekheit
- Department of Surgery, El Kabbary General Hospital, Alexandria, Egypt.
| | - Khaled Katri
- Department of Surgery, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - El-Said El-Kayal
- Department of Surgery, Faculty of Medicine, Alexandria University, Alexandria, Egypt
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11
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Karcz WK, Karcz-Socha I, Marjanovic G, Kuesters S, Goos M, Hopt UT, Szewczyk T, Baumann T, Grueneberger JM. To band or not to band--early results of banded sleeve gastrectomy. Obes Surg 2015; 24:660-5. [PMID: 24464518 DOI: 10.1007/s11695-014-1189-y] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Laparoscopic sleeve gastrectomy (LSG) is the procedure with the fastest growing numbers worldwide. Although excellent weight loss can be achieved, one major obstacle of LSG is weight regain due to sleeve dilatation. Banded sleeve gastrectomy (BLSG) has been described as an option to counteract sleeve dilatation and ameliorate weight loss over time. In a retrospective study, we analysed 25 patients who underwent BLSG using a MiniMizer® ring. Twenty five patients who had previously undergone a conventional LSG were selected for matched-pair analysis. Patient follow-up was 12 months in both groups. Mean preoperative BMI was 56.1 ± 7.2 kg/m(2) for BLSG and 57.0 ± 6.3 kg/m(2) for LSG, P = 0.522. Operative time was significantly shorter for BLSG (53 ± 27 min vs. 68 ± 20 min, P = 0.0025). Excess weight loss (%EWL) was equal in both groups with %EWL at 12 months of 58.0 ± 14.6 % for BSLG patients vs. 58.4 ± 19.2 % for LSG patients. There was no procedure-related mortality in either group. At 12 months postoperative, vomiting was significantly increased in BSLG patients (OR 6.75, P = 0.035). New onset reflux was equal in both groups (OR 0.67, P = 0.469). Ring implantation does not increase the duration of surgery or early surgical complications. Weight loss in the first follow-up year is not influenced, but the incidence of vomiting is raised after 12 months when patients start to increase eating volume.
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Affiliation(s)
- W Konrad Karcz
- Department of General Surgery, University of Schleswig-Holstein, Campus, Lübeck, Germany
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12
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Lin YH, Lee WJ, Ser KH, Chen SC, Chen JC. 15-year follow-up of vertical banded gastroplasty: comparison with other restrictive procedures. Surg Endosc 2015; 30:489-494. [PMID: 26045096 DOI: 10.1007/s00464-015-4230-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2014] [Accepted: 05/08/2015] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Vertical banded gastroplasty (VBG) has been the procedure of choice for bariatric surgeries since the 1980s. However, long-term results of VBG have been reported with different opinions, and new restrictive procedures have been innovated and showing variable results. The aim of this study is to analyze the long-term results of our VBG patients. PATIENT AND METHODS Between June 1998 and May 2002, 652 morbidly obese patients received VBG, with the initial 40 patients having open procedures and the subsequent 612 patients using a laparoscopic approach. Operative complications, weight loss, and late complications were followed and compared with groups of laparoscopic adjustable gastric banding (LAGB) and sleeve gastrectomy (LSG). RESULTS Mean age, preoperative weight, and body mass index (BMI) were 30.96 years, 108.83 kg, and 40.63 kg/m(2), respectively. The overall early postoperative complication rate was 3.4% (22/652). The excess weight loss percentages at 1, 2, 5, and 10 years were 61.04, 59.70, 51.11, and 42.0%, respectively. BMI at 1, 2, 5, and 10 years were 29.64, 29.71, 31.33, and 31.73 kg/m(2), respectively. This result is inferior to the 67% excess weight loss in the LSG group, but is higher than the 38% excess weight loss of the LAGB group. The revision rate is 13.19% (86/652) up to now. Revision surgery was required in 28 (14.0%) patients in the LAGB group and 8 (1.3%) in the LSG group. CONCLUSION VBG was an operation with acceptable outcome for treating morbid obesity and metabolic disorders. It sets a standard for new restrictive procedures.
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Affiliation(s)
- Yu-Hung Lin
- Department of Surgery, Min-Sheng General Hospital, National Taiwan University, No. 168, Chin Kuo Road, Taoyuan, Taiwan, Roc.,Department of Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, No. 123, Dapi Road, Niaosong District, Kaohsiung, Taiwan, Roc
| | - Wei-Jei Lee
- Department of Surgery, Min-Sheng General Hospital, National Taiwan University, No. 168, Chin Kuo Road, Taoyuan, Taiwan, Roc.
| | - Kong-Han Ser
- Department of Surgery, Min-Sheng General Hospital, National Taiwan University, No. 168, Chin Kuo Road, Taoyuan, Taiwan, Roc
| | - Shu-Chun Chen
- Department of Surgery, Min-Sheng General Hospital, National Taiwan University, No. 168, Chin Kuo Road, Taoyuan, Taiwan, Roc
| | - Jung-Chien Chen
- Department of Surgery, Min-Sheng General Hospital, National Taiwan University, No. 168, Chin Kuo Road, Taoyuan, Taiwan, Roc
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13
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Lytle NW, Patel AD, Toro JP, Srinivasan J, Davis SS. Reversing a Vertical Banded Gastroplasty for Obstruction: Technical Pointers. Bariatr Surg Pract Patient Care 2014. [DOI: 10.1089/bari.2014.0005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
| | - Ankit D. Patel
- Department of Surgery, Emory University, Atlanta, Georgia
| | - Juan P. Toro
- Department of Surgery, SOMA Clinic, Medellin, Colombia
| | | | - S. Scott Davis
- Department of Surgery, Emory University, Atlanta, Georgia
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Bekheit M, Katri K, Ashour MH, Sgromo B, Abou-ElNagah G, Abdel-Salam WN, Catheline JM, El Kayal ES. Gender influence on long-term weight loss after three bariatric procedures: gastric banding is less effective in males in a retrospective analysis. Surg Endosc 2014; 28:2406-11. [PMID: 24648106 DOI: 10.1007/s00464-014-3489-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2013] [Accepted: 02/14/2014] [Indexed: 02/08/2023]
Abstract
BACKGROUND Identifying factors that influence weight loss after bariatric surgery is one way to predict a successful surgical outcome. Knowledge of the effect of gender on weight loss after bariatric surgery has not been well demonstrated in the literature despite being noted in every day practice. The aim of this study was to find the influence of gender on long-term weight loss after bariatric surgery. METHODS A retrospective analysis of data retrieved from a prospectively maintained bariatric database was conducted. RESULTS The study included 640 consecutive patients. Their mean age was 38 ± 10 years, mean preoperative body mass index was 44.9 ± 8.4 kg/m2, and mean preoperative excess weight (EW %) was 108.3 ± 38.4%. The mean of the average excess weight loss (EWL %) was 43.3 ± 42.4%. Three procedures were utilized: Roux-en-Y gastric bypass (RYGB), vertical banded gastroplasty (VBG), and gastric banding (GB). Both VBG and RYGB induced significantly more EWL % than GB (d = 22.1%, p < 0.001 and d = 16, p = 0.02, respectively). In patients who underwent VBG and GB, males had significantly lower preoperative EW % (Student t = -4.86, p < 0.001, and Student t = 4.69, p < 0.001, respectively), and postoperative mean of the average EWL % (Student t = -2.43, p = 0.016, and Student t = -3.33, p = 0.002, respectively) than females. In patients who underwent RYGB, there were no differences in the preoperative EW % (t = -1.03, p = 0.309) or the mean of the average EWL % (t = 0.406, p = 0.688). The simple linear regression model used to explain the variability in EWL %, accounted for by the variability in the preoperative EW %, was significant (F = 180, p < 0.001). Analysis of the residual errors in predicting the EWL % revealed no significant difference between males and females after VBG and after RYGB (t = 0.117, p = 0.907 and t = 1.052, p = 0.3, respectively), while it was significant after GB (t = -2.999, p = 0.003). CONCLUSION From our experience, we suggest that GB not to be offered as a first choice for obese male patients.
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Affiliation(s)
- Mohamed Bekheit
- Minimal Invasive Surgery Unit, Department of Surgery, El Kabbary General Hospital, El Kabbary, Alexandria, Egypt,
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