Comparison of Sleeve Volume Between Banded and Non-banded Sleeve Gastrectomy: Midterm Effect on Weight and Food Tolerance—a Retrospective Study

Abstract

Background Sleeve dilatation after laparoscopic sleeve gastrectomy (LSG) causes weight regain (WR). Banded sleeve gastrectomy (BSG) was proposed to prevent dilatation and reduce WR. Methods A retrospective cohort study on patients who underwent BSG and LSG and completed 4 years of follow-up from 2016 to 2021 was included. Body mass index (BMI), percentage of excess weight loss (%EWL), percentage of total weight loss (%TWL), and FT scores were calculated at 1, 2, 3, and 4 years. The sleeve volume was estimated at 6 months, 1 year, and 4 years. Multi-variate analysis was conducted to assess correlations between covariates. WR was calculated as weight gain > 10%, > 10 kg above the nadir, or BMI increase of ≥ 5 kg/m 2 above the nadir. Results This study included LSG 1279 patients and BSG 132 patients. Mean %EWL at 1 year was 83.87 ± 17.25% in LSG vs. 85.71 ± 7.92% in BSG and was 83.47 ± 18.87% in LSG and 85.54 ± 7.48% in BSG at 4 years. Both had significant weight loss over time (p. < 0.001) with no significant main effect of surgery (p.0.438). Mean sleeve volume at 6 months was 102.32 ± 9.88 ± 10.28 ml in LSG vs. 101.89 ± 10.019 ml in BSG and at 4 years was 580.25 ± 112.25 ml in LSG vs. 157.94 ± 12.54 ml in BSG (p. < 0.001). WR occurred in 136 (10.6%) and 4 (3.1%) (p.0.002) in LSG and BSG patients, 90 (7%) vs. zero (0%) (p.0.002) and 31 (2.4%) vs. zero (0%) (p.0.07) using the > 10%, > 10 kg increase above the nadir and the ≥ 5 kg/m 2 BMI increases above the nadir formulas, respectively. Conclusion BSG had significantly lower sleeve volume, significantly lower WR, and significantly lower FT scores than LSG after 4 years from surgery; however, volume changes were not correlated with weight loss. Graphical Abstract

Banded Versus Non-banded Sleeve Gastrectomy: A Systematic Review and Meta-Analysis

“…2) After 12 months, seven studies, including 1,962 patients, reported this outcome with substantially greater EWL for the LBSG group with 3.30 [0.42, 6.18], the p-value was 0.02. 3) EWL was reported after 24 months of follow-up in six studies encompassing 2,007 patients [17,18,20,[22][23][24]. our analysis showed substantially higher %EWL in the LBSG group than the other group (MD=4.13; 95%CI = [1.44, 6.81]; p-value of 0.003).…”

“…We applied our inclusion and exclusion criteria, resulting in 29 articles available for full-text examination. Finally, we had 15 studies [10,[17][18][19][20][21][22][23][24][25][26][27][28][29][30] included in this systematic review meta-analysis. The PRISMA diagram depicting this selection process is shown in Figure 1.…”

“…Excess weight loss (EWL), %: EWL was evaluated at four time points: 1) after six months of follow-up, it was compared in six studies encompassing 2,011 patients with no substantial difference in EWL between LBSG and LSG groups with MD of 5.19 [-0.33, 10.72]; p-value of 0.07 [17,18,20,[22][23][24]. 2) After 12 months, seven studies, including 1,962 patients, reported this outcome with substantially greater EWL for the LBSG group with 3.30 [0.42, 6.18], the p-value was 0.02.…”

Two-Year Results of the Banded Versus Non-banded Re-sleeve Gastrectomy as a Secondary Weight Loss Procedure After the Failure of Primary Sleeve Gastrectomy: a Randomized Controlled Trial

“…However, in our study, patients had a four-fold stomach volume, which might have contributed to the weight regain since more dilation is correlated to less restriction and, therefore, more food consumption. A study by Hany et al found that in a retrospective trial with four years of follow-up after primary LSG with or without a ring, that banded LSG had significantly lower sleeve volume, significantly lower WR, and significantly lower FT scores than LSG and that the ring can work as a possible prevention against stomach enlargement [ 27 ].…”