Italian Group for Lap-Band System: results of multicenter study on patients with BMI < or =35 kg/m2.
BACKGROUND
The Lap-Band System is the most common bariatric operation world-wide. Current selection criteria do not include patients with BMI < or = 35. We report the Italian multicentre experience with BMI < or = 35 kg/m(2) over the last 5 years.


METHODS
Data were obtained from 27 centres involved in the Italian Collaborative Study Group for Lap-Band System. Detailed information was collected on a specially created electronic data sheet (MS Access 2000) on patients operated in Italy since January 1996. Items regarding patients with BMI < or = 35 were selected. Data were expressed as mean +/- SD except as otherwise indicated.


RESULTS
225 (6.8%) out of 3,319 Lap-Band patients were recruited from the data-base. 15 patients, previously submitted to another bariatric procedure (BIB =14; VBG= 1) were excluded. 210 patients were eligible for study (34M/176F, mean age 38.19+/-11.8, range 17-66 years, mean BMI 33.9+/-1.1, range 25.1-35 kg/m(2), mean excess weight 29.5+/-7.1, range 8-41). 199 comorbidities were diagnosed preoperatively in 55/210 patients (26.2%). 1 patient (0.4%) (35 F) died 20 months postoperatively from sepsis following perforation of dilated gastric pouch. There were no conversions to laparotomy. Postoperative complications presented in 17/210 patients (8.1%). Follow-up was obtained at 6, 12, 24, 36, 48 and 60 months. At these time periods, mean BMI was 31.1+/-2.15, 29.7+/-2.19, 28.7+/-3.8, 26.7+/-4.3, 27.9+/-3.2, and 28.2+/-0.9 kg/m(2) respectively. Co-morbidities completely resolved 1 year postoperatively in 49/55 patients (89.1%). At 60 months follow-up, only 1 patient (0.4%) has a BMI >30.


CONCLUSIONS
Although surgical indications for BMI < or = 35 remain questionable, the Lap-Band in this study demonstrated that all but 1 patient achieved normal weight, and most lost their co-morbidities with a very low mortality rate.
Angrisani
L
L
Italian Group for Lap-Band, c/o Fondazione IDIS, Città della Scienza, via Coroglio 156, 80124 Naples, Italy. luigiangrisani@chirurgiaobesita.it
Favretti
F
F
Furbetta
F
F
Iuppa
A
A
Doldi
S B
SB
Paganelli
M
M
Basso
N
N
Lucchese
M
M
Zappa
M
M
Lesti
G
G
Capizzi
F D
FD
Giardiello
C
C
Di Lorenzo
N
N
Paganini
A
A
Di Cosmo
L
L
Veneziani
A
A
Lacitignola
S
S
Silecchia
G
G
Alkilani
M
M
Forestieri
P
P
Puglisi
F
F
Gardinazzi
A
A
Toppino
M
M
Campanile
F
F
Marzano
B
B
Bernante
P
P
Perrotta
G
G
Borrelli
V
V
Lorenzo
M
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D015992:Body Mass Index; D005260:Female; D015391:Gastroplasty / Q000379:methods*; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000175:diagnosis / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome