Background: This study is a multicentric retrospective analysis of the results of Lap-Band System positioning in the last 10 years of clinical experience. Methods: Data were collected from the data-base of the Italian Group for LapBand System® and BIB® (GILB). Patients were allocated into two groups according to the years of adjustable gastric banding positioning. From January 1, 1996 to December 31, 2000 (Group A) and from January 1, 2001 to December 31, 2005 (Group B). Demographics, laparotomic conversion, intra- and postoperative complications, and weight loss (BMI and %EWL in patients with minimum follow-up of 3 years) were considered. Data were expressed by mean ± Standard Deviation. Statistical analysis was done with Fishers’ exact test or χ2 test with Yates correction (P<0,05 was considered significant). Results: From January 1, 1996 to December 31, 2005, 5624 patients underwent laparoscopic adjustable gastric banding (mean age 37.1±12, range 15-77 years; sex 4431F/1193M; BMI 44.8±9.1, range 30.1-83.6 kg/m2; EW 56.3±21.7, range 31-218 kg, %EW 88.2±32.9, range 44.9-295). 536 patients were excluded because the date of surgery was not reported. Group A: 2539 patients; age 42.7±10, sex 2125F/414M, BMI 44.8±7.1; EW 51.4±7.6; %EW 75.8±27.2. Group B: 2549 patients; age 40±11.7, sex 2130F/419M; BMI 46.4±6.9, EW 60.1±23.6; %EW 90.1±32.4. Band was positioned by peri-gastric access in all group A patients, while in 52.7% patients band was positioned via pars flaccida. Operative time was significantly longer in Group A (81±22 Vs 64±65 min, P<0.05). Hospital stay was similar in groups (2±2 days). 30-days mortality was recorded only in group A (2 patients with pulmonary embolism). Laparotomic conversion rate was significantly higher in group A (51 vs 8; P<0.001), mainly due to difficult surgical anatomy (41 vs 4; P<0.001), rarely for complication (8 vs 2; P<0.001). Late complication rate was higher in group A (734; 28.6% vs 172; 6.7%;P<0.001)and were mainly due to: gastric pouch dilation - slippage (365 vs 67; P<0.001); intra-gastric migration (68 vs 17; P<0.001), and tube-port failure (301 vs 88;P<0.001). Re-operation rate was also higher in Group A patients (764; 29.8% vs 271; 10.6%;P<0.001) considering both general (357; 13.9% vs 144; 5.6%; P<0,001) and local anesthesia (407; 15.9% vs 271; 10.6; P<0.01). Patients eligible at minimum 3 years follow-up were 1792/2539 and 960/2549 with mean BMI of 33.7±11.7 and 31.9±12.2, and mean %EWL of 46.8±23.8 and 50.4±21.9 in Group A and B respectively. Conclusions: Significant improvement of Lap-Band results in the 2nd five years regarding laparotomic conversion and postoperative complication rate, with similar weight loss were observed. They were obtained by the combination of growing surgical knowledge and technical progress in the prosthetic materials.
Angrisani, L., Favretti, F., Furbetta, F., Micheletto, M., Zappa, M., Paganelli, M., et al. (2007). Italian Group for Lap-band (R): Evolution of results and complications in the last 10years. OBESITY SURGERY, 17, 123-123.
Italian Group for Lap-band (R): Evolution of results and complications in the last 10years
Capizzi, F. D.;Bernante, P.;
2007
Abstract
Background: This study is a multicentric retrospective analysis of the results of Lap-Band System positioning in the last 10 years of clinical experience. Methods: Data were collected from the data-base of the Italian Group for LapBand System® and BIB® (GILB). Patients were allocated into two groups according to the years of adjustable gastric banding positioning. From January 1, 1996 to December 31, 2000 (Group A) and from January 1, 2001 to December 31, 2005 (Group B). Demographics, laparotomic conversion, intra- and postoperative complications, and weight loss (BMI and %EWL in patients with minimum follow-up of 3 years) were considered. Data were expressed by mean ± Standard Deviation. Statistical analysis was done with Fishers’ exact test or χ2 test with Yates correction (P<0,05 was considered significant). Results: From January 1, 1996 to December 31, 2005, 5624 patients underwent laparoscopic adjustable gastric banding (mean age 37.1±12, range 15-77 years; sex 4431F/1193M; BMI 44.8±9.1, range 30.1-83.6 kg/m2; EW 56.3±21.7, range 31-218 kg, %EW 88.2±32.9, range 44.9-295). 536 patients were excluded because the date of surgery was not reported. Group A: 2539 patients; age 42.7±10, sex 2125F/414M, BMI 44.8±7.1; EW 51.4±7.6; %EW 75.8±27.2. Group B: 2549 patients; age 40±11.7, sex 2130F/419M; BMI 46.4±6.9, EW 60.1±23.6; %EW 90.1±32.4. Band was positioned by peri-gastric access in all group A patients, while in 52.7% patients band was positioned via pars flaccida. Operative time was significantly longer in Group A (81±22 Vs 64±65 min, P<0.05). Hospital stay was similar in groups (2±2 days). 30-days mortality was recorded only in group A (2 patients with pulmonary embolism). Laparotomic conversion rate was significantly higher in group A (51 vs 8; P<0.001), mainly due to difficult surgical anatomy (41 vs 4; P<0.001), rarely for complication (8 vs 2; P<0.001). Late complication rate was higher in group A (734; 28.6% vs 172; 6.7%;P<0.001)and were mainly due to: gastric pouch dilation - slippage (365 vs 67; P<0.001); intra-gastric migration (68 vs 17; P<0.001), and tube-port failure (301 vs 88;P<0.001). Re-operation rate was also higher in Group A patients (764; 29.8% vs 271; 10.6%;P<0.001) considering both general (357; 13.9% vs 144; 5.6%; P<0,001) and local anesthesia (407; 15.9% vs 271; 10.6; P<0.01). Patients eligible at minimum 3 years follow-up were 1792/2539 and 960/2549 with mean BMI of 33.7±11.7 and 31.9±12.2, and mean %EWL of 46.8±23.8 and 50.4±21.9 in Group A and B respectively. Conclusions: Significant improvement of Lap-Band results in the 2nd five years regarding laparotomic conversion and postoperative complication rate, with similar weight loss were observed. They were obtained by the combination of growing surgical knowledge and technical progress in the prosthetic materials.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
