High complication rate after Swedish adjustable gastric banding in younger patients < or =25 years.
BACKGROUND
Swedish adjustable gastric banding (SAGB) is an effective treatment for morbid obesity. The main advantage of this procedure is that this operation is minimally invasive to the stomach and totally reversible and adjustable to the patient's needs. The aim of this observational study is to present our experience with patients < or =25 years old.


METHODS
Between January 1996 and January 2006, 107 patients (85 women, 22 men) of 785 consecutive patients who underwent SAGB during the study period were aged < or =25 years (13.6%). All data (demographic and morphologic data, operative data, and follow-up data) were prospectively collected in a computerized data bank. The postoperative follow-up program was performed most of the time by residents, and 17 different surgeons performed the operation.


RESULTS
The mean total weight loss was 27 kg after 1 year, reaching a total of 40 kg after 8 years. The mean EWL was 65.5% after 8 years, and the BMI decreased from 43.3 to 28.2 kg/m(2). In the 107 patients, there were 50 patients with 72 complications (46.7%) and 57 patients with no complication (53.3%). The most common complications were esophagitis (25.2%), pouch dilation (16.8%), port problems (6.5%), esophageal dilation (5.6%) and band leakage (4.7%). Overall, 31 patients (29%) needed a reoperation. There was no mortality.


CONCLUSIONS
SAGB operation and the follow-up should only be performed by a small team of bariatric surgeons. Because of the high complication and reoperation rate, a gastric-band-specific patient selection will be necessary. On the basis of 8 years follow-up, SAGB is an effective bariatric procedure for achieving weight loss.
Mittermair
Reinhard
R
Department of Surgery, University Hospital Innsbruck, Medical University Innsbruck, Anichstrasse 35, A-6020, Innsbruck, Austria. reinhard.mittermair@uki.at
Aigner
Franz
F
Obermüller
Sabine
S
D000328:Adult; D015992:Body Mass Index; D005260:Female; D015391:Gastroplasty / Q000009:adverse effects* / Q000379:methods*; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology; D012086:Reoperation / Q000706:statistics & numerical data; D015431:Weight Loss; D055815:Young Adult