Results and complications after Swedish adjustable gastric banding in older patients.
BACKGROUND
Swedish adjustable gastric banding (SAGB) is an effective treatment for morbid obesity. The aim of this study was to assess the efficacy and safety of SAGB in older patients aged >or=50 years.


METHODS
Between January 1996 and January 2006, 134 patients (102 women, 32 men) of 785 consecutive patients who underwent SAGB during the study period were aged >or=50 years. Two groups of patients were analyzed: Group 50 (n=107) patients aged 50-59 years and Group 60 (n=27) patients aged 60-69 years. All data (demographic and morphologic data, operative data, and follow-up data) were prospectively collected in a computerized databank.


RESULTS
One hundred thirty-four patients (17.1%) out of 785 entered the study. Mean percentage of excess weight loss (%EWL) was 37.5 at 1 year and 48.8 at 7 years, body mass index (BMI) fell from 43.3 to 33.1 at 7 years. In the 134 patients, there were 65 patients with 121 complications (48.5%) and 69 patients with no complication (51.5%). The most common complications were esophagitis (27%), esophageal dilation (16%), port problems (11%), pouch dilation (11%), band leakage (9%), and band migration (7%). Overall, 46 patients (34%) needed a reoperation. In Group 50, mean %EWL was 38.4 at 1 year and 54.9 at 7 years. BMI fell from 42.9 to 33.1 at 7 years. In the 107 patients, there were 55 patients with 99 complications (51%) and a reoperation rate of 35.5%. In Group 60, mean %EWL was 32.8 at 1 year and 41.2 at 7 years. BMI fell from 44.3 to 34 at 7 years. In the 27 patients, there were ten patients with 22 complications (37%) and a reoperation rate of 29.6%. There was no mortality.


CONCLUSIONS
At 7-year follow-up, for older patients, SAGB is an effective bariatric procedure for achieving weight loss. Nevertheless, based on the high complication and reoperation rate, a gastric band-specific patient selection will be necessary.
Mittermair
Reinhard P
RP
Department of Surgery, University Hospital Innsbruck, Medical University Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria. reinhard.mittermair@uki.at
Aigner
Franz
F
Obermüller
Sabine
S
D000368:Aged; D015992:Body Mass Index; D005260:Female; D015391:Gastroplasty / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery; D012086:Reoperation / Q000706:statistics & numerical data; D013548:Sweden; D016896:Treatment Outcome