Prospective evaluation and 7-year follow-up of Swedish adjustable gastric banding in adults with extreme obesity.
BACKGROUND
Swedish adjustable gastric banding (SAGB) is a widespread laparoscopic procedure in bariatric surgery. Few long-term data is available.


OBJECTIVE
To determine long-term outcome after SAGB in 196 patients studied prospectively.


METHODS
196 patients, 40 men, and 156 women have been operated from 1996 to 2005. Age was 38 +/- 1 (mean +/- sem) years. Mean follow-up was 63 +/- 2 months.


RESULTS
Hospital morbidity was 3% (0.5% early reoperation); mortality was 0. Late complications were band migration (1%), leakage (5%), slipping (4%), or pouch dilatation (8%). Minor reoperations (tube replacement, port-related, and hernias) were needed in 7.5%. Cumulative major reoperation rate reached 32%. Eighteen percent had a band replacement; 14% had removal of band anatomy. Late mortality was 0.5%. Exactly 7 years after SAGB, BMI decreased from 45 +/- 1 kg/m2 to 33 +/- 1 kg/m2, and excess weight loss (EWL) was 61 +/- 4%. Sixty-eight percent of the patients reached > or = 50% EWL.


CONCLUSIONS
In 14% of the patients, the band anatomy had to be removed. Seven years of intact band anatomy leads to a successful EWL of 61 +/- 4% and to EWL of > or = 50% in 68%. However, cumulative major reoperation rate of 32% in 7 years makes it mandatory to offer and discuss other bariatric procedures to the respective patients.
Balsiger
Bruno M
BM
Division of Visceral Surgery, Hirslanden Salem-Spital, Bern, Switzerland. bruno.balsiger@spitalnetzbern.ch
Ernst
Daniel
D
Giachino
Daniel
D
Bachmann
Ruedi
R
Glaettli
Andreas
A
D000293:Adolescent; D000328:Adult; D005260:Female; D015391:Gastroplasty; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery; D011446:Prospective Studies; D012086:Reoperation; D013548:Sweden; D016896:Treatment Outcome; D015431:Weight Loss