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.
Five-year follow-up of the Lap-Band((R)) system: Are those who fail really failures? / Angrisani, L; Favretti, F; Furbetta, F; Doldi, SB; Lattuada, E; Paganelli, M; Lucchese, M; Basso, N; Capizzi, FD; Di Lorenzo, N; Iuppa, A; Lesti, G; Giardello, C; Veneziani, A; Alkilani, M; Zappa, M; Forestieri, P; Gardinazzi, A; Puglisi, F; Cascardo, A; Bernante, P; Busetto, L. - In: OBESITY SURGERY. - ISSN 0960-8923. - ELETTRONICO. - 15:(2005), pp. 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.
