Open versus laparoscopic vertical banded gastroplasty: a randomized controlled double blind trial.
BACKGROUND
Vertical banded gastroplasty (VBG) is a frequently used surgical procedure for the treatment of morbid obesity. It can be done open (OVBG) or laparoscopic (LVBG). The aim of this double-blind randomized clinical trial was to compare the postoperative outcome and 1-year follow-up of 2 cohorts of patients who underwent either OVBG or LVBG.


METHODS
30 patients with morbid obesity were randomized into 2 groups (14 OVBG and 16 LVBG). Pain intensity, analgesic requirements, respiratory function, and physical activity were blindly analyzed during the first 3 postoperative days. Complications, weight loss, and cosmetic results after 1 year follow-up were evaluated.


RESULTS
Both groups were highly comparable before surgery. Surgical time was longer in the laparoscopic procedure. Patients in this group required less analgesics during the first postoperative day. There was an earlier recovery in the expiratory and inspiratory forces, as well as faster recovery of physical activities in patients who underwent LVBG. Postoperative complications were more frequent in the open group. Excess body weight loss after 1 year was similar in both groups. Cosmetic results were significantly better in the laparoscopic group.


CONCLUSIONS
LVBG had advantages over the open procedure in terms of analgesic requirements, respiratory function, postoperative recovery, and cosmetic results.
Dávila-Cervantes
Andrea
A
Department of Surgery, Instituto Nacional de Ciencias Medicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15, Tlalpan 14000 México City, México DF.
Borunda
Delia
D
Domínguez-Cherit
Guillermo
G
Gamino
Rosa
R
Vargas-Vorackova
Florencia
F
González-Barranco
Jorge
J
Herrera
Miguel F
MF
D000328:Adult; D004311:Double-Blind Method; D005260:Female; D015391:Gastroplasty / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000503:physiopathology / Q000601:surgery; D011028:Pneumoperitoneum, Artificial; D011184:Postoperative Period; D013147:Spirometry; D013526:Surgical Mesh; D016896:Treatment Outcome