Long-Term Matched Comparison of Adjustable Gastric Banding Versus Sleeve Gastrectomy: Weight Loss, Quality of Life, Hospital Resource Use and Patient-Reported Outcome Measures

Johari, Yazmin; Ooi, Geraldine; Burton, Paul R.; Laurie, Cheryl; Dwivedi, Shourye; Qiu, Yunfei; Chen, Richard; Loh, Damien; Nottle, Peter; Brown, Wendy A.

doi:10.1007/s11695-019-04168-w

Cited by 29 publications

(22 citation statements)

References 27 publications

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“…Even though the popularity of LAGB has been declining rapidly in the past years due to high rates of ineffective weight loss and frequent re-operations [3], the technical ease of the procedure, the low early postoperative complications, and the short length of hospitalization [3] could make it a feasible option in a selected group of patients.…”

Section: Discussionmentioning

confidence: 99%

“…This small volume of food was thought to stretch the stomach and cause early satiety. Gradual emptying of the proximal pouch into the infra-band stomach is thought to be responsible for prolonged inter-meal satiety [3]. More recently, it has been hypothesized that LAGB mechanism of action includes the induction of early and prolonged satiety; however, the intraluminal events that lead to this are far more complex than simple retention of food in the proximal pouch and merit further evaluation beyond the scope of this manuscript [4].…”

Section: Introductionmentioning

confidence: 97%

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Laparoscopic Adjustable Gastric Banding—Should a Second Chance Be Given?

et al. 2020

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Background Obesity is a chronic relapsing-remitting disease and a global pandemic, being associated with multiple comorbidities. Laparoscopic adjustable gastric banding (LAGB) is one of the safest surgical procedures used for the treatment of obesity, and even though its popularity has been decreasing over time, it still remains an option for a certain group of patients, producing considerable weight loss and improvement in obesity-associated comorbidities. Methods The aim of this study was to evaluate the impact of weight loss following LAGB on obesity-associated comorbidities, and to identify factors that could predict better response to surgery, and patient sub-groups exhibiting greatest benefit. A total of 99 severely obese patients (81.2% women, mean age 44.19 ± 10.94 years, mean body mass index (BMI) 51.84 ± 8.77 kg/m2) underwent LAGB in a single institution. Results obtained 1, 2, and 5 years postoperatively were compared with the pre-operative values using SPPS software version 20. Results A significant drop in BMI was recorded throughout the follow-up period, as well as in A1c and triglycerides, with greatest improvement seen 2 years after surgery (51.8 ± 8.7 kg/m2 vs 42.3 ± 9.2 kg/m2, p < 0.05, 55.5 ± 19.1 mmol/mol vs 45.8 ± 13.7 mmol/mol, p < 0.05, and 2.2 ± 1.7 mmol/l vs 1.5 ± 0.6 mmol/l). Better outcomes were seen in younger patients, with lower duration of diabetes before surgery, and lower pre-operative systolic blood pressure. Conclusions Younger age, lower degree of obesity, and lower severity of comorbidities at the time of surgery can be important predictors of successful weight loss, making this group of patients the ideal candidates for LAGB.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 97%

Laparoscopic Adjustable Gastric Banding—Should a Second Chance Be Given?

et al. 2020

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“…Unfortunately, post-op PA/ diet were not included in the analysis, despite that EWL was an examined outcome [32]. Another long-term matched comparison of adjustable gastric banding vs sleeve gastrectomy (matching criteria: age, weight, surgery date) did not include post-op PA/diet in the analysis, despite that mean total body WL was an examined outcome [6]. Likewise, research compared the efficacy of primary vs revisional laparoscopic RYGB using matched analysis (matching criteria: age, gender, preoperative BMI, follow-up period), but post-op PA/diet were not included in the analysis, despite that WL was an examined outcome [33].…”

Section: Examples Of Non-inclusion Of Post-op Pa and Diet In Comparismentioning

confidence: 99%

“…Yet, it is not clear why patients' post-op PA and dietary practices are not considered in such analyses. There have been calls for the comprehensive measurement of outcomes in BS [6]. However, unless there is a general belief or consensus that, post-BS, all patients are considered equal in terms of their PA and/or diet practices, comparisons of short-, medium-, or long-term effectiveness of various BS procedures, and comparisons of effectiveness of BS vs no surgery are likely to remain a reflection of the effectiveness of a given procedure, probably contaminated with the consequences of the patients' quality and extent of post-op PA/diet.…”

Section: Conclusion: Now What?mentioning

confidence: 99%

“…Comparisons of short-, medium-, or long-term effectiveness and outcomes of various bariatric surgery (BS) procedures, and comparisons of effectiveness and outcomes of BS vs no surgery usually encompass a range of variables. Important outcomes include safety (e.g., adverse events, operative mortality, perioperative complications, readmissions, long-term reoperation rates) or other relevant indicators (e.g., length of hospital stay) [1][2][3][4][5][6][7]. In addition to such variables, the indicators of effectiveness employed for comparisons frequently comprise three main components.…”

Section: Introductionmentioning

confidence: 99%

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Missing Something? Comparisons of Effectiveness and Outcomes of Bariatric Surgery Procedures and Their Preferred Reporting: Refining the Evidence Base

Ansari

El-Ansari

2020

OBES SURG

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Comparisons of effectiveness of bariatric surgery (BS) procedures encompass weight loss, metabolic/clinical outcomes, and improvements or worsening of comorbidities. Post-operative physical activity (PA) and diet influence such outcomes but are frequently not included in comparisons of effectiveness. We assessed the value and necessity of including post-operative PA/diet data when comparing effectiveness of BS. Including post-operative PA/diet data has significant benefits for BS and patients. The paper proposes an explicit preferred reporting system (Preferred REporting of post-operative PHYsical activity and Diet data in comparisons of BS effectiveness: PRE-PHYD Bariatric). Including post-operative PA/diet data could result in more accurate appraisals of effectiveness of BS procedures. This could translate into better ‘individualized’ BS by achieving a better ‘fit’ between patient and procedure.

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Effect of Bariatric Surgery on Risk of Complications After Total Knee Arthroplasty

et al. 2022

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Key Points Question Does bariatric surgery reduce complication risk after total knee arthroplasty (TKA) in patients with severe obesity? Findings In this randomized clinical trial of 82 adults aged 65 years and younger with class II obesity, those who were scheduled to undergo TKA experienced fewer joint surgery complications after undergoing a bariatric procedure, compared with those who underwent TKA without weight loss intervention. Meaning The findings suggest that people with severe obesity and knee osteoarthritis should seek to lose weight before considering TKA, and weight loss appears to reduce the complications of joint surgery.

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Long-Term Matched Comparison of Adjustable Gastric Banding Versus Sleeve Gastrectomy: Weight Loss, Quality of Life, Hospital Resource Use and Patient-Reported Outcome Measures

Cited by 29 publications

References 27 publications

Laparoscopic Adjustable Gastric Banding—Should a Second Chance Be Given?

Laparoscopic Adjustable Gastric Banding—Should a Second Chance Be Given?

Missing Something? Comparisons of Effectiveness and Outcomes of Bariatric Surgery Procedures and Their Preferred Reporting: Refining the Evidence Base

Effect of Bariatric Surgery on Risk of Complications After Total Knee Arthroplasty

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