Risk factors for the intermediate outcome of morbid obesity after laparoscopically placed adjustable gastric banding.
BACKGROUND
The overall long-term results of medical treatment for morbid obesity are poor. Surgery is the only treatment option to obtain long-term weight reduction. Analysis of risk factors for treatment success of laparoscopically placed gastric banding (LGB) has not been available until now.


METHODS
Prospective study with 99 patients with LGB between January 1997 and July 2003. The parameters assessed as risk factors included onset of obesity, feeling of postprandial satiety, and initial body mass index (BMI).


RESULTS
Median follow-up was 36 months (3 to 72). Independent prognostic factors of excess body weight reduction (>25%) were for the first postoperative year: onset of obesity as an adolescent (relative risk [RR] 0.21), an initial BMI <45 kg/m(2) (RR 4.76), and a BMI between 45.1 and 50 kg/m(2) (RR 3.23). After the second year, independent prognostic factors were as follows: feeling of postprandial satiety (RR 5.26) and an initial BMI <45 kg/m(2) (RR 3.03).


CONCLUSIONS
LGB is suitable to achieve intermediate weight reduction in patients with morbid obesity. To obtain the best results, patients should be treated before they achieve a BMI >45 kg/m(2). Additionally a postprandial feeling of satiety after LGB is mandatory for good long-term results.
Thomusch
Oliver
O
Department of General and Visceral Surgery, Albert-Ludwigs University of Freiburg, Hugstetter Strasse 55, 79106 Frieburg, Germany. o.thomusch@gmx.de
Keck
Tobias
T
Dobschütz
Ernst V
EV
Wagner
Christoph
C
Rückauer
Klaus Dieter
KD
Hopt
Ulrich Theodor
UT
D000328:Adult; D000368:Aged; D015992:Body Mass Index; D001835:Body Weight; D005260:Female; D015391:Gastroplasty / Q000009:adverse effects* / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects* / Q000379:methods; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009767:Obesity, Morbid / Q000150:complications*; D018579:Patient Selection; D011183:Postoperative Complications; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D015431:Weight Loss