Long-term results, late complications and quality of life in a series of adjustable gastric banding.
BACKGROUND
Adjustable gastric banding is currently the most common bariatric operation. This study is a retrospective analysis of the Finnish experience with this procedure over the last 10 years.


METHODS
Between March 1993 and June 1999, 123 patients underwent either open (36) or laparoscopic (87) surgery for morbid obesity by the application of an adjustable gastric band. Data on preoperative clinical characteristics and postoperative outcome and weight-loss patterns up to 9 years (mean 55 months) are presented and also evaluated by the Bariatric Analysis and Reporting Outcome System (BAROS). Sex ratio was 31% males / 69% females, mean age 44 years and mean +/- SD preoperative BMI 49 +/- 8 kg/m(2) (range 33.6-85.1).


RESULTS
During the evaluation period (March 1993 December 2002), 54% of patients experienced postoperative complications requiring hospital treatment >or= 7 days, and 52% underwent a reoperation. 33% of bands were removed. The most important late complications were esophagitis (30%), obstruction due to slippage / pouch dilatation (21%), incisional hernia (9%) and band erosion (9%). Mean excess weight loss at 1 and 2 year follow-up was 36% and 38%, which later stabilized to 30%. During the evaluation period, there were 10 deaths, 2 of which were 30-day deaths, and the remainder were not associated with the band. According to BAROS, the outcome was regarded as "very good" in 3%, "good" in 7%, "fair" in 40% and "failure" in 50%.


CONCLUSIONS
Our long-term data found that weight reduction is acceptable,but the incidence of late complications and reoperations was high.
Martikainen
Tarja
T
Division of Clinical Nutrition, Kuopio University Hospital, University of Kuopio, Finland. tarja.martikainen@kuh.fi
Pirinen
Elina
E
Alhava
Esko
E
Poikolainen
Eero
E
Pääkkönen
Matti
M
Uusitupa
Matti
M
Gylling
Helena
H
D000328:Adult; D000368:Aged; D015897:Comorbidity; D005260:Female; D015391:Gastroplasty / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000453:epidemiology / Q000601:surgery; D011183:Postoperative Complications; D011788:Quality of Life; D012086:Reoperation; D012189:Retrospective Studies; D016896:Treatment Outcome; D015431:Weight Loss