Laparoscopic Adjustable Gastric Banding in 1,791 Consecutive Obese Patients: 12-Year Results

Favretti, Franco; Segato, G; Ashton, David; Busetto, Luca; Luca, Maurizio De; Mazza, M.; Ceoloni, Andrea; Banzato, Oscar; Calò, E; Enzi, Giuliano

doi:10.1007/s11695-007-9043-0

Cited by 227 publications

(160 citation statements)

References 19 publications

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“…Male sex may lead to more complications due to increased technical difficulty caused by a higher BMI, more visceral fat, and potentially more advanced comorbidities (47)(48)(49). In the U.S. (52), in various European countries (53,54), as well as in New Zealand (55), ϳ80% of bariatric surgery patients are women. The proportion of men undergoing bariatric surgery does not reflect the sex distribution of morbid obesity.…”

Section: Perioperative Risk and Care Of Bariatricmentioning

confidence: 99%

Bariatric Surgery in Patients With Morbid Obesity and Type 2 Diabetes

Schernthaner

Morton

2008

Diabetes Care

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Section: Perioperative Risk and Care Of Bariatricmentioning

confidence: 99%

Bariatric Surgery in Patients With Morbid Obesity and Type 2 Diabetes

Schernthaner

Morton

2008

Diabetes Care

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“…In this context, bariatric surgery attains more weight loss than any non-surgical intervention, 21 although it has not been compared with GLP-1 agonist treatment, but this is at the expense of cost, mortality, morbidity and frequently adverse quality of life outcomes. [22][23][24][25][26] Noting that in some individual patients weight loss was >20 kg, it seems appropriate to call for quality RCTs to evaluate GLP-1 agonist therapy for weight loss against forms of bariatric surgery and, indeed, as a deflector for bariatric surgery in those who qualify under NICE guidance. Our conviction, based upon this experience, is that all patients destined for surgical intervention should be assessed for medical therapy with GLP-1 agonist therapy prior to proceeding.…”

Section: Discussionmentioning

confidence: 99%

The use of GLP-1 agonist therapy, liraglutide, is associated with significant weight loss in morbidly obese people without diabetes

Gillani

Singh

2015

Br J Diabetes

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“…Although gastric banding comes with the risk of both minor and major complications and some patients may require additional surgery, 5,6 studies on gastric banding and other types of bariatric surgery suggest that these procedures can lead to improvements in morbidity and mortality among obese patients. 7,8 (However, participants in such studies often have BMIs higher than those who have become eligible for gastric banding as a result of the revised eligibility criteria.)…”

Section: Gastric Banding and Patient Autonomy: Grounds For Cautionmentioning

confidence: 99%

Gastric Banding: Ethical Dilemmas in Reviewing Body Mass Index Thresholds

Voigt

Schmidt

2011

Mayo Clinic Proceedings

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O n February 16, the US Food and Drug Administration (FDA) revised the indication criteria for gastric banding, reducing the body mass index (BMI) threshold for patients with obesity-related health problems from 35 to 30 kg/m 2 and dropping the requirement that comorbid conditions be severe. Despite a recommendation of its advisory board for a similar 5-point reduction for obese people without associated health problems, the BMI threshold of 40 kg/m 2 was left unchanged for this group. The FDA's decision is reported to make an additional 26.4 million Americans eligible for banding. 1The immediate press reactions criticized the limited evidence supporting the decision and raised concerns about the role of lap-band manufacturer Allergan, who petitioned the FDA for lower BMI thresholds and stands to profit from the new guidelines. Others expressed worries about those who do not meet the stipulated BMI thresholds and would be denied the procedure. Is the unaltered BMI threshold for patients without comorbid conditions justifiable? Is the 5-point reduction for those with obesity-related conditions sufficient, or is it going too far? Concerns about the limitations of the BMI, BMI categories, and their relationships to health outcomes 2-4 add further complexity to this debate. These and related issues have not been settled once and for all with the FDA's revisions. They are likely to resurface as new procedures for bariatric surgery and data about their risks and benefits become available because obesity remains high on the public health agenda.The deliberations of the FDA and its advisory board focused on issues of safety, effectiveness, and the quality of the available data. However, reference to medical risks and benefits alone does not resolve all current and future debates. Nor should it be assumed that no further questions arise as long as patients understand and voluntarily accept the risks that are deemed acceptable by experts. For the use of gastric banding, and bariatric surgery more generally, is caught in a moral crosswind, buffeted by business interests and the ethics of personal responsibility. Although decisions about gastric banding ideally would be based on a case-by-case assessment with due attention to patients' health status, medical histories, and circumstances, for policy purposes more robust guidance is required to determine appropriate eligibility criteria. (In practice, of course, access to the intervention will also depend on coverage criteria imposed by third-party payers; for the purposes of this commentary, we leave aside this issue.)

show abstract

Laparoscopic Adjustable Gastric Banding in 1,791 Consecutive Obese Patients: 12-Year Results

Abstract: LAGB can achieve effective, safe and stable long-term weight loss. In experienced hands, the complication rate is low. Follow-up is paramount.

Cited by 227 publications

References 19 publications

Bariatric Surgery in Patients With Morbid Obesity and Type 2 Diabetes

Bariatric Surgery in Patients With Morbid Obesity and Type 2 Diabetes

The use of GLP-1 agonist therapy, liraglutide, is associated with significant weight loss in morbidly obese people without diabetes

Gastric Banding: Ethical Dilemmas in Reviewing Body Mass Index Thresholds

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