Annals of Surgery

Skip Navigation LinksHome > November 2010 - Volume 252 - Issue 5 > 10-year Follow-up of Laparoscopic Vertical Banded Gastroplas...
Annals of Surgery:
doi: 10.1097/SLA.0b013e3181fd35b0
Original Articles from the ESA Proceedings

10-year Follow-up of Laparoscopic Vertical Banded Gastroplasty: Good Results in Selected Patients

Scozzari, Gitana MD; Toppino, Mauro MD; Famiglietti, Federico MD; Bonnet, Gisella MD; Morino, Mario MD

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Objective: To evaluate the long-term results of laparoscopic vertical banded gastroplasty (VBG) for morbid obesity.

Background: Laparoscopic VBG, a safe and straightforward bariatric procedure characterized by good short-term results, has been progressively replaced by other more complex procedures on the basis of a presumed high rate of long-term failure. Nevertheless, some authors have recently reported long-term efficacy in selected patients.

Methods: All patients who underwent laparoscopic VBG were included in a prospective database. Patients reaching 10-year follow-up received a complete evaluation including clinical, endoscopic, and biochemical examinations.

Results: Between January 1996 and March 1999, 266 morbidly obese patients underwent bariatric procedures. Among them, 213 were selected for laparoscopic VBG; exclusion criteria were as follows: contraindications to pneumoperitoneum, gastroesophageal reflux disease, and psychological contraindications to restrictive procedures. Mean age, preoperative weight, and body mass index were 36.9 years, 123.6 kg, and 45.4 kg/m2, respectively. Intraoperative complication rate and conversion rate were 0.9% and 0.9%, respectively. Early postoperative complication rate was 4.2% and early reoperation rate was 0.5%. Mean hospital length of stay was 6.3 days. Mortality was nil. The 10-year follow-up rate was 70.4% (150 patients). Late postoperative complication rate was 14.7%, and 10-year revisional surgery rate was 10.0%. The excess weight loss percentages at 3, 5, and 10 years were 65.0%, 59.9%, and 59.8%, respectively. The resolution and/or improvement rate for comorbidity were 47.5% for hypertension, 55.6% for diabetes, 75% for sleep apnea, and 47.4% for arthritis. Mean Moorehead-Ardelt Quality of Life Questionnaire and BAROS values were 1.4 and 3.8, respectively.

Conclusions: The present study demonstrates that laparoscopic VBG in carefully selected patients leads to long-term results comparable with more complex and invasive procedures. Given the low postoperative morbidity for laparoscopic VBG, its present clinical role should be, in our opinion, reevaluated.

© 2010 Lippincott Williams & Wilkins, Inc.


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