Skip to main content
Top
Published in: Obesity Surgery 7/2013

01-07-2013 | Clinical Research

Long-Term Outcomes of Laparoscopic Adjustable Silicone Gastric Banding (LAGB) in Moderately Obese Patients With and Without Co-morbidities

Authors: Luigi Angrisani, Pier Paolo Cutolo, Giampaolo Formisano, Gabriella Nosso, Antonella Santonicola, Giuliana Vitolo

Published in: Obesity Surgery | Issue 7/2013

Login to get access

Abstract

Background

Overweight and obesity independently increase cardiovascular risk, while even modest weight loss can result in clinically significant improvements in cardiovascular risk and reduce long-term mortality. Lowering the body mass index (BMI) threshold for bariatric surgery to those with moderate obesity might be one way to lower the burden of this disease. The aim of this study was to evaluate the efficacy and safety of laparoscopic adjustable silicone gastric banding (LAGB) in moderately obese subjects with or without obesity-related co-morbidities.

Methods

Thirty-four patients with BMI between 30 and 35 kg/m2 (5 males/29 females, mean age 36 ± 10 years, mean preoperative weight 87.9 ± 7.1 kg, mean BMI 32.6 ± 1.6 kg/m2 and mean percentage excess weight 48.7 ± 9 %) who underwent LAGB via pars flaccida between June 1, 2002 and August 31, 2010 were included. Good response was defined as BMI <30 kg/m2 or percentage estimated weight loss (%EWL) >50. Poor response was defined as BMI >30 kg/m2 or %EWL less than 50 after a minimum of 1 year.

Results

Mean weight, BMI and %EWL were recorded at 1, 3, 5 and 7 years and were 77.4 ± 7.6, 69.9 ± 10.8, 70.9 ± 9.3 and 73.3 ± 12.0 kg; 28.8 ± 2.9, 26.4 ± 3.2, 26.5 ± 3.4 and 27.4 ± 5.0 kg/m2; and 36 ± 23, 46.1 ± 33.8, 58.6 ± 31.5 and 45 ± 57, respectively (p < 0.01). Co-morbidities were diagnosed in 17/34 (50 %) patients at baseline and underwent remission or improvement in all cases after 1 year.

Conclusions

LAGB in a safe and effective procedure in patients with a BMI <35 kg/m2.
Literature
1.
go back to reference Clegg A, Colquitt J, Sidhu M, et al. Clinical and cost effectiveness of surgery for morbid obesity: a systematic review and economic evaluation. Int J Obes. 2003;27:1167–77.CrossRef Clegg A, Colquitt J, Sidhu M, et al. Clinical and cost effectiveness of surgery for morbid obesity: a systematic review and economic evaluation. Int J Obes. 2003;27:1167–77.CrossRef
2.
go back to reference Kenchaiah S, Evans JC, Levy D, et al. Obesity and the risk of heart failure. N Engl J Med. 2002;347:305–13.PubMedCrossRef Kenchaiah S, Evans JC, Levy D, et al. Obesity and the risk of heart failure. N Engl J Med. 2002;347:305–13.PubMedCrossRef
3.
go back to reference Logue J, Murray HM, Welsh P, et al. Obesity is associated with fatal coronary heart disease independently of traditional risk factors and deprivation. Heart. 2011;97:564–8.PubMedCrossRef Logue J, Murray HM, Welsh P, et al. Obesity is associated with fatal coronary heart disease independently of traditional risk factors and deprivation. Heart. 2011;97:564–8.PubMedCrossRef
4.
go back to reference Eeg-Olofsson K, Cederholm J, Nilsson PM, et al. Risk of cardiovascular disease and mortality in overweight and obese patients with type 2 diabetes: an observational study in 13,087 patients. Diabetologia. 2009;52:65–73.PubMedCrossRef Eeg-Olofsson K, Cederholm J, Nilsson PM, et al. Risk of cardiovascular disease and mortality in overweight and obese patients with type 2 diabetes: an observational study in 13,087 patients. Diabetologia. 2009;52:65–73.PubMedCrossRef
5.
go back to reference Lavie CJ, Milani RV, Ventura HO. Obesity and cardiovascular disease: risk factor, paradox, and impact of weight loss. J Am Coll Cardiol. 2009;53:1925–32.PubMedCrossRef Lavie CJ, Milani RV, Ventura HO. Obesity and cardiovascular disease: risk factor, paradox, and impact of weight loss. J Am Coll Cardiol. 2009;53:1925–32.PubMedCrossRef
6.
go back to reference Christou NV, Sampalis JS, Liberman M, et al. Surgery decreases long-term mortality, morbidity, and health care use in morbidly obese patients. Ann Surg. 2004;240:416–24.PubMedCrossRef Christou NV, Sampalis JS, Liberman M, et al. Surgery decreases long-term mortality, morbidity, and health care use in morbidly obese patients. Ann Surg. 2004;240:416–24.PubMedCrossRef
7.
go back to reference Chapman AE, Kiroff G, Game P, et al. Laparoscopic adjustable gastric banding in the treatment of obesity: a systematic review. Surgery. 2004;135:326–51.PubMedCrossRef Chapman AE, Kiroff G, Game P, et al. Laparoscopic adjustable gastric banding in the treatment of obesity: a systematic review. Surgery. 2004;135:326–51.PubMedCrossRef
8.
go back to reference Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004;292:1724–37.PubMedCrossRef Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004;292:1724–37.PubMedCrossRef
9.
go back to reference Schwartz MW, Woods SC, Seeley RJ, et al. Is the energy homeostasis system inherently biased toward weight gain? Diabetes. 2003;52:232–8.PubMedCrossRef Schwartz MW, Woods SC, Seeley RJ, et al. Is the energy homeostasis system inherently biased toward weight gain? Diabetes. 2003;52:232–8.PubMedCrossRef
10.
go back to reference Favretti F, Segato G, Ashton D, et al. Laparoscopic adjustable gastric banding in 1,791 consecutive obese patients: 12-year results. Obes Surg. 2007;17:168–75.PubMedCrossRef Favretti F, Segato G, Ashton D, et al. Laparoscopic adjustable gastric banding in 1,791 consecutive obese patients: 12-year results. Obes Surg. 2007;17:168–75.PubMedCrossRef
11.
go back to reference Weiner R, Blanco-Engert R, Weiner S, et al. Outcome after laparoscopic adjustable gastric banding - 8 years’ experience. Obes Surg. 2003;13:427–34.PubMedCrossRef Weiner R, Blanco-Engert R, Weiner S, et al. Outcome after laparoscopic adjustable gastric banding - 8 years’ experience. Obes Surg. 2003;13:427–34.PubMedCrossRef
12.
go back to reference Dargent J. Surgical treatment of morbid obesity by adjustable gastric band: the case for a conservative strategy in the case of failure—a 9-year series. Obes Surg. 2004;14:986–90.PubMedCrossRef Dargent J. Surgical treatment of morbid obesity by adjustable gastric band: the case for a conservative strategy in the case of failure—a 9-year series. Obes Surg. 2004;14:986–90.PubMedCrossRef
13.
go back to reference Hollenbeaks CS, Rogers AM, Barrus B, et al. Surgical volume impacts bariatric surgery mortality: a case for centers of excellence. Surgery. 2008;144:736–43.CrossRef Hollenbeaks CS, Rogers AM, Barrus B, et al. Surgical volume impacts bariatric surgery mortality: a case for centers of excellence. Surgery. 2008;144:736–43.CrossRef
14.
go back to reference Parikh M, Laker S, Weiner M, et al. Objective comparison of complications resulting from laparoscopic bariatric procedures. J Am Coll Surg. 2006;202:252–61.PubMedCrossRef Parikh M, Laker S, Weiner M, et al. Objective comparison of complications resulting from laparoscopic bariatric procedures. J Am Coll Surg. 2006;202:252–61.PubMedCrossRef
15.
go back to reference Cobourn C, Mumford D, Chapman MA, et al. Laparoscopic gastric banding is safe in outpatient surgical centers. Obes Surg. 2010;20:415–22.PubMedCrossRef Cobourn C, Mumford D, Chapman MA, et al. Laparoscopic gastric banding is safe in outpatient surgical centers. Obes Surg. 2010;20:415–22.PubMedCrossRef
17.
go back to reference Iovino P, Angrisani L, Galloro G, et al. Proximal stomach function in obesity with normal or abnormal oesophageal acid exposure. Neurogastroenterol Motil. 2006;18(6):425–32.PubMedCrossRef Iovino P, Angrisani L, Galloro G, et al. Proximal stomach function in obesity with normal or abnormal oesophageal acid exposure. Neurogastroenterol Motil. 2006;18(6):425–32.PubMedCrossRef
18.
go back to reference Angrisani L, Lorenzo M, Borrelli V. Laparoscopic adjustable gastric banding versus Roux-en-Y gastric bypass: 5-year results of a prospective randomized trial. Surg Obes Relat Dis. 2007;3:127–33.PubMedCrossRef Angrisani L, Lorenzo M, Borrelli V. Laparoscopic adjustable gastric banding versus Roux-en-Y gastric bypass: 5-year results of a prospective randomized trial. Surg Obes Relat Dis. 2007;3:127–33.PubMedCrossRef
19.
go back to reference O’Brien PE, McPhail T, Chaston TB, et al. Systematic review of medium-term weight loss after bariatric operations. Obes Surg. 2006;16:1032–40.PubMedCrossRef O’Brien PE, McPhail T, Chaston TB, et al. Systematic review of medium-term weight loss after bariatric operations. Obes Surg. 2006;16:1032–40.PubMedCrossRef
20.
go back to reference Favretti F, Ashton D, Busetto L, et al. The gastric band: first-choice procedure for obesity surgery. World J Surg. 2009;33:2039–48.PubMedCrossRef Favretti F, Ashton D, Busetto L, et al. The gastric band: first-choice procedure for obesity surgery. World J Surg. 2009;33:2039–48.PubMedCrossRef
21.
go back to reference Burns EM, Naseem H, Bottle A, et al. Introduction of laparoscopic bariatric surgery in England: observational population cohort study. BMJ. 2010;341:c4296.PubMedCrossRef Burns EM, Naseem H, Bottle A, et al. Introduction of laparoscopic bariatric surgery in England: observational population cohort study. BMJ. 2010;341:c4296.PubMedCrossRef
22.
go back to reference Buchwald H, Williams SE. Bariatric surgery worldwide 2003. Obes Surg. 2003;14:1157–64.CrossRef Buchwald H, Williams SE. Bariatric surgery worldwide 2003. Obes Surg. 2003;14:1157–64.CrossRef
23.
go back to reference Dixon JB, Straznicky NE, Lambert EA, et al. Surgical approaches to the treatment of obesity. Nat Rev Gastroenterol Hepatol. 2011;8:429–37.PubMedCrossRef Dixon JB, Straznicky NE, Lambert EA, et al. Surgical approaches to the treatment of obesity. Nat Rev Gastroenterol Hepatol. 2011;8:429–37.PubMedCrossRef
24.
25.
go back to reference Micheletto G, Roviaro G, Lattuada E, et al. Adjustable gastric banding for morbid obesity. Our experience. Ann Ital Chir. 2006;77:397–400.PubMed Micheletto G, Roviaro G, Lattuada E, et al. Adjustable gastric banding for morbid obesity. Our experience. Ann Ital Chir. 2006;77:397–400.PubMed
26.
go back to reference Dargent J. Laparoscopic adjustable gastric banding: lessons from the first 500 patients in a single institution. Obes Surg. 1999;9:446–52.PubMedCrossRef Dargent J. Laparoscopic adjustable gastric banding: lessons from the first 500 patients in a single institution. Obes Surg. 1999;9:446–52.PubMedCrossRef
27.
go back to reference Torchia F, Mancuso V, Civitelli S, et al. LapBand System in super-super obese patients (60 kg/m2): 4-year results. Obes Surg. 2009;19:1211–5.PubMedCrossRef Torchia F, Mancuso V, Civitelli S, et al. LapBand System in super-super obese patients (60 kg/m2): 4-year results. Obes Surg. 2009;19:1211–5.PubMedCrossRef
28.
go back to reference Watkins BM, Ahroni JH, Michaelson R, et al. Laparoscopic adjustable gastric banding in an ambulatory surgery center. Surg Obes Rel Dis. 2008;4(Suppl):S56–62.CrossRef Watkins BM, Ahroni JH, Michaelson R, et al. Laparoscopic adjustable gastric banding in an ambulatory surgery center. Surg Obes Rel Dis. 2008;4(Suppl):S56–62.CrossRef
29.
go back to reference te Riele WW, Boerma D, Wiezer MJ, et al. Long-term results of laparoscopic adjustable gastric banding in patients lost to follow-up. Br J Surg. 2010;97:1535–40.CrossRef te Riele WW, Boerma D, Wiezer MJ, et al. Long-term results of laparoscopic adjustable gastric banding in patients lost to follow-up. Br J Surg. 2010;97:1535–40.CrossRef
30.
go back to reference Sivagnanam P, Rhodes M. The importance of follow-up and distance from centre in weight loss after laparoscopic adjustable gastric banding. Surg Endosc. 2010;24:2432–8.PubMedCrossRef Sivagnanam P, Rhodes M. The importance of follow-up and distance from centre in weight loss after laparoscopic adjustable gastric banding. Surg Endosc. 2010;24:2432–8.PubMedCrossRef
31.
go back to reference Angrisani L, Favretti F, Furbetta F, et al. Italian Group for Lap-Band System: results of multicenter study on patients with BMI ≤35 kg/m2. Obes Surg. 2004;14:415–8.PubMedCrossRef Angrisani L, Favretti F, Furbetta F, et al. Italian Group for Lap-Band System: results of multicenter study on patients with BMI ≤35 kg/m2. Obes Surg. 2004;14:415–8.PubMedCrossRef
Metadata
Title
Long-Term Outcomes of Laparoscopic Adjustable Silicone Gastric Banding (LAGB) in Moderately Obese Patients With and Without Co-morbidities
Authors
Luigi Angrisani
Pier Paolo Cutolo
Giampaolo Formisano
Gabriella Nosso
Antonella Santonicola
Giuliana Vitolo
Publication date
01-07-2013
Publisher
Springer-Verlag
Published in
Obesity Surgery / Issue 7/2013
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-013-0877-3

Other articles of this Issue 7/2013

Obesity Surgery 7/2013 Go to the issue