Study: Long Term Outcomes of Lap Band

http://archsurg.ama-assn.org/cgi/content/short/archsurg.2011 .45


Long-term Outcomes of Laparoscopic Adjustable Gastric Banding

Jacques Himpens, MD; Guy-Bernard Cadière, MD, PhD; Michel Bazi, MD; Michael Vouche, MD; Benjamin Cadière, MD; Giovanni Dapri, MD
 

Arch Surg. Published online March 21, 2011. doi:10.1001/archsurg.2011.45

Objective  To determine the long-term efficacy and safety of laparoscopic adjustable gastric banding (LAGB) for morbid obesity.
Author Affiliation: The European School of Laparoscopic Surgery, Department of Gastrointestinal Surgery, Saint Pierre University Hospital, Brussels, Belgium.

Design  Clinical assessment in the surgeon's office in 2009 (12 years after LAGB).

Setting  University obesity center in Brussels, Belgium.

Patients  A total of 151 consecutive patients who had benefited from LAGB between January 1, 1994, and December 31, 1997, were contacted for evaluation.

Intervention  Laparoscopic adjustable gastric banding.

Main Outcome Measures  Mortality rate, number of major and minor complications, number of corrective operations, number of patients who experienced weight loss, evolution of comorbidities, patient satisfaction, and quality of life were evaluated.

Results  The median age of patients was 50 years (range, 28-73 years). The operative mortality rate was zero. Overall, the rate of follow-up was 54.3% (82 of 151 patients). The long-term mortality rate from unrelated causes was 3.7%. Twenty-two percent of patients experienced minor complications, and 39% experienced major complications (28% experienced band erosion). Seventeen percent of patients had their procedure switched to laparoscopic Roux-en-Y gastric bypass. Overall, the (intention-to-treat) mean (SD) excess weight loss was 42.8% (33.92%) (range, 24%-143%). Thirty-six patients (51.4%) still had their band, and their mean excess weight loss was 48% (range, 38%-58%). Overall, the satisfaction index was good for 60.3% of patients. The quality-of-life score (using the Bariatric Analysis and Reporting Outcome System) was neutral.

Conclusion  Based on a follow-up of 54.3% of patients, LAGB appears to result in a mean excess weight loss of 42.8% after 12 years or longer. Of 78 patients, 47 (60.3%) were satisfied, and the quality-of-life index was neutral. However, because nearly 1 out of 3 patients experienced band erosion, and nearly 50% of the patients required removal of their bands (contributing to a reoperation rate of 60%), LAGB appears to result in relatively poor long-term outcomes.

 

Did you happen to notice the number of patients and dates of this study?? Not to be disrespectful, I am sure you mean well, but the last patients studied were banded 14 years ago! The Pars Flaccida method of fixing the band in place by suturing was adopted in 2000....so this study is completely irrelevant to today's bands and banding surgical technique!

Patients A total of 151 consecutive patients who had benefited from LAGB between January 1, 1994, and December 31, 1997, were contacted for evaluation.

I don't think there is any benefit in posting this other than to again throw an outdated study out there to scare people away from banding...really bad and transparent attempt...sorry.

By definition the surgeries would have to be old in order for it to be a Long-Term study. 

This was a recent study that I ran across this morning.  since this is a weight loss surgery board, it seemed to be the appropriate place to share it.

If you know anything of my previous posting history, I ALWAYS encourage people to learn about the risks and benefits of every surgery type, including RNY (the one that I had).

By definition the surgeries would have to be old in order for it to be a Long-Term study. 

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^^^^^^^^^
This.

Everyone is always lamenting "there are no LONG TERM STUDIES"; then, when one is done it is discounted.

I don't think the OP was "bashing the band"; she was posting information. Use it/believe it/discount it....whatever you want. 

You have had your band LESS THEN A YEAR. Please look us up in 14 years and tell us how you are doing. Information is powerful. Being territorial over your surgery choice is like a dog peeing on a tree and marking it's territory

Hey Punkin...back off.  I was simply pointing out that this study taken out of context of all the other studies that are out there is irrelevant and doesn't reflect the surgeries being done today...that is like trying to buy a 2012 Ford based on the 1997 Ford review in consumer reports.  It isn't the same product.
There are other studies out there that are larger and do not support the conclusions of this study.  BTW, I am well aware of all of the "faults" of my band and don't feel the need to encourage anyone to have banding surgery over another type of surgery.  My message to anyone investigating WLS is to encourage them to do their research and make up their own mind based on their needs, medical history and their doctor's recommendation.  I am much to "old" to go around ******g on other peoples "trees"...what do you suppose the purpose of SoBlessed's post was, if not to spread a little RNY "pee" on the lapband "tree"???

" RNY pee on the Lap Band tree "

 "There are other studies out there that are larger and do not support the conclusions of this study."

There are plenty of studies out there that *do* support the conclusions of this study. In particular, there are studies that show a reoperation rate of up to 40% in band patients 5 years out. There are plenty of studies showing EWL of around 40-50% as well.

It was the re-operation rate that scared me off from getting a band. I didn't want to have a second operation and I figure, if I was just going to end up with a VSG anyway, why not just get one to start with?

 You're welcome.