Experiences of two centers of bariatric surgery in the treatment of intragastrale band migration after gastric banding-the importance of the German multicenter observational study for quality assurance in obesity surgery 2005 and 2006.
BACKGROUND
Adjustable silicone gastric banding (ASGB) is an effective treatment in morbid obesity. Band migration is a long-term complication. Causes, clinical symptoms, timing and incidence are investigated in single centres only. In Germany, since January 1st, 2005, practice in bariatric surgery has been investigated in German prospective multicenter trial for quality assurance in obesity surgery.


METHODS
All patients underwent ASGB in two centres of bariatric surgery in Germany were prospectively registered using a computer-based data form. Patients with band migration were retrospectively evaluated, in particular, causes and characteristics of its management. The results were correlated with data obtained from the German prospective multicentre trial.


RESULTS
In total, 493 patients were enrolled in the study from February 1995 to February 2007. The follow-up rate was 79.9% (mean follow-up time period, 78.7 months; range, 2-148 months). Fifteen patients (3.0%) developed migration. In 14 cases, migration occurred within the range of 30-86 months after implantation. In one case, migration occurred 10 months after repositioning of the band. In the German multicentre trial, 629 patients underwent surgery during 2005 and 827 patients in 2006. In both periods, 74.4% of the patients were female and 25.6% male. The most frequently performed operation was ASGB (46.8%) followed by Roux-en-Y gastric bypass (38.5%).


CONCLUSIONS
Band migration requires band removal. Different symptoms and complications influence the kind of band removal. Multicentre data were evident in the case of high long-term complication rate after ASGB. Data of the German multicentre trial show the trend from restrictive bariatric procedures to malabsorptive approach.
Department of General, Abdominal and Pediatric Surgery, Municipal Hospital Teaching Hospital of the Friedrich-Schiller University at Jena, Germany, Strasse des Friedens 122, 07548, Gera, Germany. Christine.Stroh@wkg.srh.de
C
C
Stroh
U
U
Hohmann
U
U
Will
R
R
Flade-Kuthe
B
B
Herbig
S
S
Höhne
H
H
Köhler
P
P
Pick
Th
T
Horbach
R
R
Weiner
S
S
Wolff
H
H
Lippert
A M
AM
Wolf
U
U
Schmidt
F
F
Meyer
Th
T
Manger
D000293:Adolescent; D000328:Adult; D000368:Aged; D050110:Bariatric Surgery / Q000379:methods; D020878:Device Removal / Q000379:methods*; D016099:Endoscopy, Gastrointestinal; D005260:Female; D005500:Follow-Up Studies; D005548:Foreign-Body Migration / Q000453:epidemiology / Q000209:etiology / Q000601:surgery*; D015391:Gastroplasty / Q000009:adverse effects* / Q000295:instrumentation; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000601:surgery*; D011183:Postoperative Complications; D011446:Prospective Studies; D011785:Quality Assurance, Health Care / Q000379:methods*; D012086:Reoperation; D013997:Time Factors; D017211:Treatment Failure; D055815:Young Adult