Banded Gastric Bypass: Better Long-Term Results? A Cohort Study with Minimum 5-Year Follow-Up - PubMed (original) (raw)

Banded Gastric Bypass: Better Long-Term Results? A Cohort Study with Minimum 5-Year Follow-Up

Luc Lemmens. Obes Surg. 2017 Apr.

Abstract

Background: While gastric bypass has been the treatment of choice for morbid obesity, insufficient weight loss and even weight regain has been observed in a sub-group of patients. Dilatation of the pouch, pouch outlet, and proximal alimentary limb have been suggested to cause weight regain on the long term. The banded gastric bypass surgery has been introduced to overcome this problem.

Methods: Four hundred thirty-two patients (n = 254, non-banded/n = 178, banded-GaBP Ring™) were followed-up for 5 years. Patients were evaluated for weight loss, % excess weight loss (%EWL), weight regain and BMI.

Results: No significant differences between groups in the first year following surgery were observed in terms of weight loss and %EWL. %EWL at 5 years was as follows: non-banded 65.2 ± 20.0 %; banded 74.0 ± 15.1 %. At 5 years, the banded group showed more weight loss (non-banded 35.4 ± 12.5; banded 43.9 ± 11.9 kg, P < 0.0001); weight regain was significantly higher in the non-banded group (P < 0.0001). Only minor complications were reported; no signs of ring migration or slippage were reported.

Conclusion: Although, following the first year after surgery, no differences in treatment groups were observed in terms of weight loss, 5 years following surgery, patients who received banded surgery maintained better weight loss and had less weight regain compared to the non-banded group. These results suggest that laparoscopic banded gastric bypass using a silastic ring was effective in maintaining weight loss on the long term, while the complication rate was low. The banded gastric bypass is regarded by us as the new gold standard.

Keywords: %EWL; BMI; Banded gastric bypass; Silastic ring; Weight loss; Weight regain.

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Conflict of interest statement

Conflict of Interest

The author received no financial or other compensation for this work as author of the manuscript. Manuscript development was shared with A.R. Salomons (Factory CRO for Medical Devices, The Netherlands), under CRO contract with Bariatric Solutions GmbH, Switzerland.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent was obtained from all individual participants included in the study. There is no identifying information included in this article.

Figures

Fig. 1

Fig. 1

Evolution of weight loss. Data are displayed as mean weight loss in kg during the study period. Overall, these results show that over the first year, weight loss between banded and non-banded diverged quickly and over the next 4 years, while when weight loss was still divergent, there was a significant difference between the group’s average weight loss

Fig. 2

Fig. 2

%EWL at 5 years follow-up. Data are displayed as the %EWL achieved by each patient at the 5 years follow-up visit in the non-banded and banded treated patients. Lines indicate the mean %EWL for each group (non-banded 65 %; banded 74 %). A bold line indicates the %EWL of 50 %: 79.3 % of the non-banded patients had %EWL >50 % (20.7 % had <50 %EWL); the banded patients had 92.4 % >50 %EWL (7.6 % had <50 %EWL)

Fig. 3

Fig. 3

Evolution of %BMI Loss. Data are displayed as mean BMI during the study period. Overall, while the banded group had a higher BMI than the non-banded group over the first 12 months, it had a greater rate of decreasing. Significant more %BMI loss was observed for the banded group compared to the non-banded group at 1 and 5 years post-surgery (Asterisk)

Fig. 4

Fig. 4

Weight regain at 5 years. Data are displayed as the % of patients who had an increase in BMI points at the 5-year follow-up period. Results show that the banded group had less weight gain compared to the non-banded group (P < 0.0001)

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