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  • Title: Long-term efficacy of a low-pressure adjustable gastric band in the treatment of morbid obesity.
    Author: Anwar M, Collins J, Kow L, Toouli J.
    Journal: Ann Surg; 2008 May; 247(5):771-8. PubMed ID: 18438114.
    Abstract:
    OBJECTIVE: To determine the long-term efficacy and safety of a low-pressure adjustable gastric band in the treatment for morbid obesity and to detect whether age, gender, or preoperative body mass index (BMI) has an impact on the outcome. BACKGROUND: It is well known that low-pressure adjustable gastric bands such as the Swedish adjustable gastric bands (SAGB) lead to weight loss. However, very few long-term studies have been published and questions remain regarding long-term efficacy and safety, and whether any of the patient's demographic parameters including age, gender, or initial BMI impact the long-term outcome. METHODS: Six hundred consecutive patients who had a SAGB inserted between August 1996 and October 2005 were evaluated with regard to their initial BMI, age, and sex. RESULTS: There were 488 females and 112 males, with mean age 45.3 +/- 9.1, mean BMI 42.9 +/- 7.2 kg/m2, and mean weight 119.6 +/- 23.9 kg. Overall morbidity was 25.7% (10.4% perioperative, whereas 15.3% on long term). The following data represents 2, 3, 5, and 7 years of follow-up respectively. Mean BMI decreased to 30.9, 30.5, 32.7, and 31.2 kg/m2, whereas mean percentage excess weight loss (%EWL) was 60.5%, 61.5%, 53.2%, and 61.2%. Patients with BMI (<40 kg/m2) lost 63.7%, 61.2%, 45.5%, and 66.1% of their excess weight, whereas patients with BMI (40-49.9 kg/m2) lost 60.1%, 61.3%, 59.4%, and 66.6%, patients with BMI (50-50.9 kg/m2) lost 57.5%, 67.5%, 49.3%, and 40.2%, and patients with BMI (>60 kg/m2) lost 42.2%, 46.3%, 38.7%, and 40.2%. Female patients %EWL were 62.2%, 62.1%, 55.1%, and 62.3%, whereas male %EWL were 54.1%, 59.1%, 42.1%, and 51.3%. Patients <40 years %EWL were 61.8%, 62.5%, 57.1%, and 86.2%, whereas >40 years %EWL were 60.1%, 61.2%, 52.4%, and 60.1%. CONCLUSION: The SAGB is effective in achieving long-term sustainable weight loss with an acceptably low complication rate. Bands are effective regardless of patients' age and gender. Furthermore, preoperative BMI up to 60 kg/m2 does not influence the outcome.
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