Outcome and Complications after Laparoscopic Swedish Adjustable Gastric Banding: 5-Year Results of a Prospective Clinical Trial

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Abstract

Background

Bariatric surgery is currently the only effective treatment for morbid obesity in terms of inducing and maintaining satisfactory weight loss and decreasing weight-related co-morbidities. A study was conducted to assess the effects, complications and outcome after laparoscopic Swedish adjustable gastric banding (SAGB) to 5 years.

Methods

Between June 1998 and December 2005, all patients with implantation of a SAGB were enrolled in a prospective clinical trial. Results were recorded and classified, with special regard to long-term complications and re-operation rate.

Results

SAGB was performed in 128 patients (87 female, 41 male). Mean age was 40.2 ± 5.3 years, with mean preoperative BMI 44.5 ± 3.9 kg/m2. Overall mortality was 0%. Patient follow-up was 94.5%. BMI after 1, 2 and 5 years was 35.7 ± 3.7 kg/m2 (P< 0.005), 33.7 ± 3.8 kg/m2 (P< 0.001) and 31.8 ± 3.8 kg/m2 (P< 0.001), respectively. Mean EWL after 1, 2 and 5 years was 33.3 ± 6.8% (P< 0.005), 45.5 ± 6.4% (P< 0.001) and 57.4 ± 6.5% (P< 0.001), respectively. The nonresponder rate (EWL< 30%) after 2 and 5 years was 17.0% and 6.8%, respectively. The early complication rate (<30 d) was 6.25% (8/128), with 5 minor and 3 major complications. Late complications (>30 d) occurred in 10.9% (14/128), of whom 2 were minor and 12 were major complications. The overall re-operation rate was 11.7% (15/128).

Conclusions

At 5-year follow-up, laparoscopic SAGB is a safe and effective surgical treatment for morbid obesity. Our results appear to confirm that SAGB is a safer surgical treatment regarding rate and severity of complications compared with gastric bypass and malabsorptive procedures.

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