5-year outcomes of 1-stage gastric band removal and sleeve gastrectomy

Alqahtani, Aayed R.; Elahmedi, Mohamed; Qahtani, Awadh R. Al; Yousefan, Ahmad; Al-Zuhair, Ahmed R.

doi:10.1016/j.soard.2016.05.017

Cited by 19 publications

(12 citation statements)

References 30 publications

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“…A similar rate of recurrence of obesity (29–75%) is reported by other authors [10, 20, 21]. While approaching revisional bariatric surgery after failed LAGB, LSG and LRYGB are safe procedures [21, 22]. The one-stage surgical approach seems to be as safe as two-stage, yet there are only a few studies evaluating these approaches [23].…”

Section: Discussionsupporting

confidence: 54%

Revisional bariatric surgery after failed laparoscopic adjustable gastric banding - a single-center, long-term retrospective study.

Kowalewski¹,

Olszewski²,

Paśnik³

2017

Videosurgery and Other Miniinvasive Techniques

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IntroductionLaparoscopic adjustable gastric banding (LAGB) used to be one of the most popular bariatric procedures.AimTo present our institution’s experience with LAGB, its complications, causes of failure and revisional bariatric procedures, in a long-term follow-up.Material and methodsRecords of patients who underwent pars flaccida LAGB from 2003 to 2006 were gathered. We selected data on patients with a history of additional bariatric procedures. Their initial demographic data, body mass index and causes of revision were gathered. We analyzed length of stay and early perioperative complications.Results60% of patients (n = 57) who underwent LAGB in our institution between 2003 and 2006 had their band removed (out of 107, 11% lost to follow-up). Median time to revisional surgery was 50 months. The main reasons for removal were: weight regain (n = 23; 40%), band slippage (n = 14; 25%), and pouch dilatation (n = 9; 16%). Thirty (53%) patients required additional bariatric surgery, 10 (33%) of which were simultaneous with band removal. The most popular procedures were: laparoscopic Roux-en-Y gastric bypass (LRYGB) (n = 15; 50%), open gastric bypass (n = 8; 27%), and laparoscopic sleeve gastrectomy (LSG) – (n = 3; 10%). Mean length of stay (LOS) was 5.4 ±2.0. One (3%) perioperative complication was reported.ConclusionsThe results show that LAGB is not an effective bariatric procedure in long-term follow-up due to the high rate of complications causing band removal and the high rate of obesity recurrence. Revisional bariatric surgery after failed LAGB may be performed in a one-stage approach with band removal.

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Section: Discussionsupporting

confidence: 54%

Revisional bariatric surgery after failed laparoscopic adjustable gastric banding - a single-center, long-term retrospective study.

Kowalewski¹,

Olszewski²,

Paśnik³

2017

Videosurgery and Other Miniinvasive Techniques

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“…In the first systematic review comparing outcomes of revisional LSG and RYGB to their primary procedures, Mahawar and co-workers found rLSG to have acceptable safety and significant but somewhat reduced weight loss [34]. Although some observational rLSG studies reported very high rates of weight loss reaching 70.0-75.0% EWL, these findings apply to results in the early and intermediate time frames (≤ 5 years) [35,36]. To our knowledge, the number of directly comparative studies of pLSG and rLSG in patients with severe obesity with long-term ≥ 5-year followup similar to the current study (combined mean 9.…”

Section: Discussionmentioning

confidence: 99%

Long-Term Matched Comparison of Primary and Revisional Laparoscopic Sleeve Gastrectomy

et al. 2023

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Background Reports of long-term (> 5–15-year) outcomes assessing the safety and efficacy of primary revisional laparoscopic sleeve gastrectomy (LSG) are few. Methods Retrospective long-term comparisons of primary (pLSG) and revisional (rLSG) procedures were matched for gender, age ± 5 years, and body mass index (BMI) ± 5 kg/m 2 . Weight loss, associated medical condition status, and patient satisfaction were evaluated. Results Between May 1, 2006, and December 31, 2016, 194 matched patients with severe obesity (mean BMI 44.1 ± 6.7 kg/m 2 ; age 44.2 ± 10.0 years, 67.0% female) underwent pLSG ( n = 97) or rLSG ( n = 97) and were followed for a mean 12.1 ± 1.5 vs 7.6 ± 2.1 years. Respective mean weight regain from nadir was 15.0 ± 14.4 kg vs 11.9 ± 12.2 kg. Respective percent mean total weight loss and excess weight loss were 20.9 ± 12.7% and 51.8 ± 33.1%, and 18.3 ± 12.8% and 43.4 ± 31.6% at last follow-up, with no significant difference between groups. Resolution of type 2 diabetes (HbA1 C < 6.5%, off medications) was 23.1% vs 11.1%; hypertension 36.0% vs 16.0%; and hyperlipidemia 37.1% vs 35.3%. Patients in the pLSG group were significantly more satisfied with LSG (59.8% vs 43.3%, p < 0.05) and more likely to choose the procedure again. Conclusions There were no significant differences in long-term weight loss or associated medical condition outcomes in matched pLSG and rLSG patients. Graphical Abstract

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“…3,16 It could also be a result of surgical technique: Barrett et al used a single-stage conversion, Carandina et al and Silecchia et al employed a 2-stage conversion, and Huang et al used both (though the majority were in 2 stages). 3,16,[25][26][27] In the present study, no major adverse events occurred in either cohort following ESG. Thus, while the weight loss effect is attenuated compared to primary ESG, those with prior LAGB did not experience an increased incidence of leaks or abscesses, which had been a hypothesized risk from the known perigastric and intragastric fibrosis that results from LAGB.…”

Section: Discussionmentioning

confidence: 39%

Outcomes of Endoscopic Sleeve Gastroplasty Following Laparoscopic Adjustable Gastric Band: A Propensity Score–matched Analysis

Maselli,

Wooley,

Lee

et al. 2024

Surgical Laparoscopy, Endoscopy &Amp; Percutaneous Techniques

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Background: The performance of endoscopic sleeve gastroplasty (ESG) in patients with prior laparoscopic adjustable gastric band (LAGB) has not been characterized. Materials and Methods: This is a retrospective propensity score–matched study of ESG after LAGB at 2 centers with expertise in bariatric endoscopy. The primary outcome was total weight loss (TWL) at 12 months. Secondary outcomes included TWL at 3 and 6 months, 12-month excess weight loss (EWL), procedural characteristics, predictors of TWL, and serious adverse events. Results: Twenty-six adults (88.5% female, age 50.8 y, BMI 36.5 kg/m2) with prior LAGB (median duration 8 y) underwent ESG at a median of 3 years after LAGB removal. A 2:1 age-matched, sex-matched, and BMI-matched comparator group was created, comprising ESG patients from the same organization and time frame but without prior LAGB. TWL for the LAGB-to-ESG cohort versus the ESG-only cohort was 10.1±5.5% versus 13.0±4.4% at 3 months (P=0.0256), 12.4±7.2% versus 16.0±5.4% at 6 months (P=0.0375), and 12.7±8.2% versus 18.4±6.5% at 12 months (P=0.0149). At 12 months, the LAGB-to-ESG cohort had an EWL of 52.5±50.0%, and 75% achieved TWL ≥10%. There was no association between TWL at 3, 6, or 12 months and the following traits: age or BMI at the time of ESG, patient sex, and time from LAGB removal to ESG. No serious adverse events occurred in either cohort. Conclusion: ESG after LAGB facilitates safe and clinically meaningful weight loss but is attenuated compared to primary ESG.

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5-year outcomes of 1-stage gastric band removal and sleeve gastrectomy

Cited by 19 publications

References 30 publications

Revisional bariatric surgery after failed laparoscopic adjustable gastric banding - a single-center, long-term retrospective study.

Revisional bariatric surgery after failed laparoscopic adjustable gastric banding - a single-center, long-term retrospective study.

Long-Term Matched Comparison of Primary and Revisional Laparoscopic Sleeve Gastrectomy

Outcomes of Endoscopic Sleeve Gastroplasty Following Laparoscopic Adjustable Gastric Band: A Propensity Score–matched Analysis

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