Laparoscopic adjustable silicone gastric banding vs laparoscopic vertical banded gastroplasty in morbidly obese patients: long-term results of a prospective randomized controlled clinical trial.
BACKGROUND
Aim of the study is to present long-term results of a prospective randomized single-institution clinical trial comparing laparoscopic adjustable silicone gastric banding (LASGB) with laparoscopic vertical banded gastroplasty (LVBG) in morbid obesity.


METHODS
A total of 100 morbidly obese patients (body mass index 40 to 50 kg/m2) were randomized to LASGB (n=49) or LVBG (n=51) and followed up for a minimum of 7 years.


RESULTS
Mean operative time was 65.4 min in LASGBs and 94.2 min in LVBGs (p<0.05); mean hospital stay was 3.7 and 6.6 days, respectively (p<0.05). Late complication rates were 36.7% in LASGBs vs 15.7% in LVBGs at 3 years (p<0.05), 46.9% vs 43.1% at 5 years (NS), and 55.1% vs 47.1% at 7 years (NS). Late reoperation rates were 28.6% in LASGBs and 2.0% in LVBGs at 3 years (p<0.001), 38.8% and 2.0% at 5 years (p<0.001), and 46.9% and 7.8% at 7 years (p<0.001). Excess weight loss in LASGBs was 41.8% at 3 years, 33.2% at 5 years, and 29.9% at 7 years; excess weight loss in LVBGs was 60.9%, 57%, and 53.1%, respectively (p<0.05).


CONCLUSIONS
This study demonstrates that in a carefully selected group of patients, LVBG is significantly more effective than LASGB in terms of late complications, late reoperations, and long-term results on weight loss.
Scozzari
Gitana
G
Digestive Surgery and Center for Minimal Invasive Surgery, Department of Surgery, University of Turin, C.so A.M. Dogliotti 14, 10126, Turin, Italy.
Farinella
Eleonora
E
Bonnet
Gisella
G
Toppino
Mauro
M
Morino
Mario
M
D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D015391:Gastroplasty / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology; D011446:Prospective Studies; D012086:Reoperation / Q000706:statistics & numerical data; D012828:Silicones / Q000627:therapeutic use; D016896:Treatment Outcome; D015431:Weight Loss; D055815:Young Adult
D012828:Silicones