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Long-term Efficacy of a Low-pressure Adjustable Gastric Band in the Treatment of Morbid Obesity

Anwar, Mohamed MS; Collins, Jane; Kow, Lilian PhD, FRACS; Toouli, James PhD, FRACS

doi: 10.1097/SLA.0b013e31816bcd28
Original Articles

Objective: To determine the long-term efficacy and safety of a low-pressure adjustable gastric band in the treatment for morbid obesity and to detect whether age, gender, or preoperative body mass index (BMI) has an impact on the outcome.

Background: It is well known that low-pressure adjustable gastric bands such as the Swedish adjustable gastric bands (SAGB) lead to weight loss. However, very few long-term studies have been published and questions remain regarding long-term efficacy and safety, and whether any of the patient's demographic parameters including age, gender, or initial BMI impact the long-term outcome.

Methods: Six hundred consecutive patients who had a SAGB inserted between August 1996 and October 2005 were evaluated with regard to their initial BMI, age, and sex.

Results: There were 488 females and 112 males, with mean age 45.3 ± 9.1, mean BMI 42.9 ± 7.2 kg/m2, and mean weight 119.6 ± 23.9 kg. Overall morbidity was 25.7% (10.4% perioperative, whereas 15.3% on long term). The following data represents 2, 3, 5, and 7 years of follow-up respectively. Mean BMI decreased to 30.9, 30.5, 32.7, and 31.2 kg/m2, whereas mean percentage excess weight loss (%EWL) was 60.5%, 61.5%, 53.2%, and 61.2%. Patients with BMI (<40 kg/m2) lost 63.7%, 61.2%, 45.5%, and 66.1% of their excess weight, whereas patients with BMI (40–49.9 kg/m2) lost 60.1%, 61.3%, 59.4%, and 66.6%, patients with BMI (50–50.9 kg/m2) lost 57.5%, 67.5%, 49.3%, and 40.2%, and patients with BMI (>60 kg/m2) lost 42.2%, 46.3%, 38.7%, and 40.2%. Female patients %EWL were 62.2%, 62.1%, 55.1%, and 62.3%, whereas male %EWL were 54.1%, 59.1%, 42.1%, and 51.3%. Patients <40 years %EWL were 61.8%, 62.5%, 57.1%, and 86.2%, whereas >40 years %EWL were 60.1%, 61.2%, 52.4%, and 60.1%.

Conclusion: The SAGB is effective in achieving long-term sustainable weight loss with an acceptably low complication rate. Bands are effective regardless of patients' age and gender. Furthermore, preoperative BMI up to 60 kg/m2 does not influence the outcome.

To determine the long-term efficacy and safety of a low-pressure adjustable gastric band in the treatment for morbid obesity and to detect whether age, gender, or preoperative body mass index has an impact on the outcome.

From the Department of General and Digestive Surgery, Flinders Medical Center and Adelaide Bariatric Center, South Australia, Australia.

Dr. M. Anwar was funded by a Fellowship from the Egyptian Government. Johnson & Johnson Medical provided partial funding for the development of the database.

Reprints: J. Toouli, PhD, FRACS, Department of General and Digestive Surgery, Flinders Medical Centre, Flinders Drive, Bedford Park, South Australia 5042, Australia. E-mail: jim.toouli@flinders.edu.au.

© 2008 Lippincott Williams & Wilkins, Inc.