Thirteen years of follow-up in patients with adjustable silicone gastric banding for obesity: weight loss and constant rate of late specific complications.
BACKGROUND
Despite its simplicity, safety and good short-term results, progressive weight regain and a high incidence of complications have been reported after the adjustable silicone gastric banding (ASGB). The aim of this study is to evaluate the long-term results of this operation in our patient population.


METHODS
Between 1990 and 1996, 45 morbidly obese patients underwent insertion of an ASGB. The trend of the patients' BMI over time was studied using a linear mixed effect model adjusted for the preoperative BMI. So as to estimate the cumulative probability of band removal and the cumulative hazard function, Lambda(t) Kaplan-Meier analysis was used.


RESULTS
1 year after the operation, the average BMI was 79% of its preoperative value, which then increased linearly over time. The slope of the regression line was estimated at beta =0.42, indicating an average increase of 0.42 BMI units per year. 27 bands (60%) were removed because of specific late complications. The cumulative risk of band removal increased linearly with time. The hazard rate was estimated to be lambda =0.008 events/patient/month, corresponding to 0.1 events/patient/year.


CONCLUSIONS
ASGB yielded good short-term results, but the progressive weight regain and constant risk of complications in the long term tend to nullify the optimism.
Camerini
Giovanni
G
Department of Surgery, School of Medicine, University of Genoa, Italy.
Adami
Gianfranco
G
Marinari
Giuseppe Maria
GM
Gianetta
Ezio
E
Pretolesi
Fabio
F
Papadia
Francesco
F
Marini
Paola
P
Murelli
Federica
F
Carlini
Flavia
F
Stabilini
Cesare
C
Sormani
Maria Pia
MP
Scopinaro
Nicola
N
D000328:Adult; D017677:Age Distribution; D015992:Body Mass Index; D005260:Female; D005500:Follow-Up Studies; D015905:Gastric Balloon; D015391:Gastroplasty / Q000009:adverse effects* / Q000379:methods*; D006801:Humans; D015994:Incidence; D007558:Italy; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000175:diagnosis / Q000601:surgery*; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology*; D011336:Probability; D012008:Recurrence; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D012828:Silicones; D013997:Time Factors; D016896:Treatment Outcome; D015431:Weight Loss
D012828:Silicones