Stoma adjustable silicone gastric banding versus vertical banded gastroplasty for the treatment of morbid obesity.
BACKGROUND
Among gastric restrictive operations, the procedure of choice is still controversial. The aim of this study is to compare the results of two different gastric restrictive procedures: vertical banded gastroplasty (VBG) and stoma adjustable silicone gastric banding (ASGB).


METHODS
Between 1991 and 1996, 51 patients were treated surgically for morbid obesity: 27 underwent VBG and 24 underwent ASGB. Preoperative body weight (BW), body mass index (BMI) and percentage of ideal body weight (% IBW) were (mean+/-SD): 145.7+/-45.3 kg; 53.9+/-15.9 kg/m2; 249.1+/-73.5% respectively in the VBG group. Corresponding figures for the ASBG group were 132.5+/-22.7 kg; 46.9 7.8 kg/m2 and 207.2+/-35.0%.


RESULTS
In the VBG group, the median follow-up period was 26 months (range: 7-47). Eighteen months after the operation BW, BMI, % IBW and percentage of excess weight loss (% EWL) were 85.5+/-26.8 kg, 31.9+/-9.8 kg/m2, 145.4+/-43.9% and 74+/-1% respectively. Complications included incisional hernia (n=1), and bowel obstruction (n=1). One patient died of acute myocardial infarction on the third postoperative day. In the ASGB group, median follow-up time was 19.7 months (range: 18-26). At 18 months postoperation BW, BMI, % IBW and % EWL values were 86.6+/-20.6 kg 30.6+/-6.6 kg/m2 140.6+/-29.3% and 64+/-1% respectively. Gastric wall erosion occurred in two patients and the bands had to be removed. These patients underwent VBG 6 months later. Complications encountered in this group were incisional hernia (n=1), outlet stenosis and reflux esophagitis (n=1), reservoir leakage (n=1) and gastrointestinal bleeding (n=1). Two patients died of pulmonary embolism and acute gastrointestinal bleeding.


CONCLUSIONS
Weight reduction was not statistically significant between the two groups. ASGB was easier to perform and less invasive than VBG.
Taşkin
M
M
Istanbul University, Cerrahpaşa Medical Faculty, General Surgery Department, Turkey.
Apaydin
B B
BB
Zengin
K
K
Taşkin
U
U
D000328:Adult; D015992:Body Mass Index; D005260:Female; D005500:Follow-Up Studies; D015391:Gastroplasty / Q000379:methods*; D005774:Gastrostomy / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D008297:Male; D009767:Obesity, Morbid / Q000601:surgery*; D011183:Postoperative Complications; D012189:Retrospective Studies; D012826:Silicone Elastomers; D016896:Treatment Outcome; D015431:Weight Loss
D012826:Silicone Elastomers