Background: Studies on causes of failure of Lap-Band are lacking, and criteria of success in obesity surgery remain controversial. Aim of this study is the retrospective evaluation of 5-year follow-up in patients with a Lap-Band which failed in terms of weight loss alone, according to Reinhold's criteria for laparotomic gastric bypass. Methods: Patients operated until December 1999 by the Lap- Band® System were recruited from the data-base of GILB. According to Reinhold's criteria, in this study were included only patients whose weight exceeded their ideal body weight (IBW) by 100% or 45.5 kg. Failure was considered a final excess weight (EW) <75% of IBW at 5 years follow-up. Initial BMI and age range were considered. Data were expressed as mean±standard devi- ation. Statistical analysis was done by means of Student t-test, and P<0.05 was considered significant. Results: After 5 years, 1,120 patients were eligible: 41 were debanded, 259 were excluded because of initial weight <100% of IBW, 50 have incomplete data, and 297 were lost. 155/473 (32.7%) patients were EW<75% of their IBW. According to their initial BMI range, a progressive significant (P<0.001) less weight loss is observed with increased range: 14.1%, 29%, 48.8%, 63.8% and 78.2% in patients among 40.1-45, 45.1-50, 50.1-55, 55.1-60, and >60 kg/m2. According to patients’ age at time of sur- gery, a significant (P<0.001) less weight loss is obtained in patients among 51-60 (35.4%) and >60 (50%) years versus patients among 21-30 (20%) and 31-40 (21.7%) years. Conclusions: According to the Reinhold criteria, 155/782(19.8%) patients have a little weight loss. In this little sub- group, preoperative BMI>50 and age>50 are predictive of less weight loss after 5 years in patients with gastric banding. Looking at weight loss alone, without considering patient satisfaction or health improvements, is perhaps a very simplistic way to exam- ine a complex situation. New and original criteria have to be developed to evaluate gastric band results.
Angrisani, L., Favretti, F., Furbetta, F., Doldi, S.B., Lattuada, E., Paganelli, M., et al. (2005). Five-year follow-up of the Lap-Band((R)) system: Are those who fail really failures?. OBESITY SURGERY, 15, 934-934.
Five-year follow-up of the Lap-Band((R)) system: Are those who fail really failures?
Capizzi, FD;Bernante, P;
2005
Abstract
Background: Studies on causes of failure of Lap-Band are lacking, and criteria of success in obesity surgery remain controversial. Aim of this study is the retrospective evaluation of 5-year follow-up in patients with a Lap-Band which failed in terms of weight loss alone, according to Reinhold's criteria for laparotomic gastric bypass. Methods: Patients operated until December 1999 by the Lap- Band® System were recruited from the data-base of GILB. According to Reinhold's criteria, in this study were included only patients whose weight exceeded their ideal body weight (IBW) by 100% or 45.5 kg. Failure was considered a final excess weight (EW) <75% of IBW at 5 years follow-up. Initial BMI and age range were considered. Data were expressed as mean±standard devi- ation. Statistical analysis was done by means of Student t-test, and P<0.05 was considered significant. Results: After 5 years, 1,120 patients were eligible: 41 were debanded, 259 were excluded because of initial weight <100% of IBW, 50 have incomplete data, and 297 were lost. 155/473 (32.7%) patients were EW<75% of their IBW. According to their initial BMI range, a progressive significant (P<0.001) less weight loss is observed with increased range: 14.1%, 29%, 48.8%, 63.8% and 78.2% in patients among 40.1-45, 45.1-50, 50.1-55, 55.1-60, and >60 kg/m2. According to patients’ age at time of sur- gery, a significant (P<0.001) less weight loss is obtained in patients among 51-60 (35.4%) and >60 (50%) years versus patients among 21-30 (20%) and 31-40 (21.7%) years. Conclusions: According to the Reinhold criteria, 155/782(19.8%) patients have a little weight loss. In this little sub- group, preoperative BMI>50 and age>50 are predictive of less weight loss after 5 years in patients with gastric banding. Looking at weight loss alone, without considering patient satisfaction or health improvements, is perhaps a very simplistic way to exam- ine a complex situation. New and original criteria have to be developed to evaluate gastric band results.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
