[Are there predictive items of successful surgery in morbid obesity treated by adjustable gastric banding: a prospective study].
BACKGROUND
Surgical treatment of morbid obesity by perigastric adjustable banding give at mid term follow up, contrasted results which associate success, failure and intermediate situations.


OBJECTIVE
The objective of this work was to prospectively validate predicting items that would predict success in the surgical treatment of morbid obesity by adjustable gastric banding.


METHODS
Eighty patients with morbid obesity have been treated with adjustable gastric banding. Seventy-one women, and nine men with a mean age of 37.8 years (20-59) with a mean follow up of 17 months (12-52). They have been classified in three groups: success, failure, and intermediate results. Uni- and multivariate analysis was performed on six criteria: age, sex, professional activity, metabolic disorders, length of obesity and body mass index (BMI).


RESULTS
Concerning age, sex, professional activity, metabolic disorders, and length of obesity, there was no difference between the three groups. However, a BMI more than 50 kg/m(2) has a strong predictive value. Patients called "super obese", BMI >50, has a high rate of failure (64%) even the weight loss is often important in absolute value, but the BMI at the follow up remain high and more than 40. In this situation: gastric banding does not seem a good treatment because it does not protect these patients against the lethal risk of their comorbidities.


CONCLUSIONS
In this study, there is not a specific candidate "profile" to a successful treatment of morbid obesity by adjustable gastric banding. Meanwhile the initial BMI appear to be a predictive factor of success or failure. In the case of patients with high BMI >50 (super obese) gastric banding did not seen to be a good treatment and another technical approach (gastric bypass) must be discussed.
Polliand
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Service de chirurgie digestive, hôpital Jean-Verdier (AP-HP), université Paris-XIII, UFR Léonard-de-Vinci (Bobigny), avenue du 14-juillet, 93143 Bondy cedex, France. claude.polliand@jvr.ap-hop-paris.fr
Rizk
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Barrat
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Champault
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D000328:Adult; D015992:Body Mass Index; D005260:Female; D005602:France; D015391:Gastroplasty / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009767:Obesity, Morbid / Q000601:surgery*; D017063:Outcome Assessment, Health Care; D011446:Prospective Studies