Surgical treatment of morbid obesity with vertical banded gastroplasty: a comparison between TA90-4.8 and TA90-B.
BACKGROUND
In this study, we wanted to determine the results of vertical banded gastroplasty for morbid obesity and compare the results of using the TA90-4.8 with using the TA90-B instrument.


METHODS
Patients with body weight over 100% of or 45 kg above their ideal body weight, body mass index (BMI) over 40 kg/m2, or BMI over 35 kg/m2 with osteoarthritis, venous stasis, sleep apnoea, or frequent abortion were selected for surgical intervention. They were purposely divided into two groups. Vertical banded gastroplasty was performed in group A with two applications of TA90-4.8 (N = 26) and in group B with one application of TA90-B (N = 24). The outlet of the gastric pouch was 10 to 12 mm and reinforced with a 1.5 cm strip of Marlex to give a circumference of 5.5 cm. The follow-up body weight, BMI, and percentage of weight in excess of the ideal weight were compared between the two groups. The results were classified as excellent (0 to 25% excess weight), fair (26 to 50% excess weight), good (51 to 75% excess weight), poor (76 to 100% excess weight), and worse (> 100% excess weight). A failure was defined as a body weight of greater than 76% excess weight and a repeated operation being needed regardless of the ultimate outcome.


RESULTS
There were no differences between the two groups regarding age, gender, preoperative body weight, BMI, and excess weight. The operative time was longer for group A (175 +/- 39 min) than for of group B (140 +/- 23 min) (p < 0.0001). In the follow-up period, the postoperative body weight, BMI, and excess weight showed no differences between the two groups. Four patients in group A had poor results, three due to staple disruption and one due to sweet-eating. One patient in group B had stenosis of the stomach pouch and needed another operation to release the stenosis. Thus, five failures (10%) were found in this study.


CONCLUSIONS
Vertical banded gastroplasty is an effective modality for treating morbid obesity. Two applications of TA90-4.8 are not recommended because they result in frequent staple disruption.
Chou
F F
FF
Department of Surgery, Chang Gung Memorial Hospital, Kaohsiung, Chang Gung University, Taiwan, R.O.C.
Hsieh
K C
KC
Wu
C H
CH
D000328:Adult; D000367:Age Factors; D005260:Female; D015391:Gastroplasty / Q000379:methods*; D006801:Humans; D008297:Male; D009767:Obesity, Morbid / Q000601:surgery*; D012737:Sex Factors; D013528:Surgical Staplers