Banded sleeve gastrectomy--initial experience.
BACKGROUND
Isolated sleeve gastrectomy is being used with increasing frequency for the treatment of morbid obesity. This study was done to determine the potential benefit of placing a band of processed human dermis around the upper portion of a sleeve gastrectomy to prevent late dilatation and weight gain.


METHODS
Twenty-seven patients underwent a sleeve gastrectomy followed by placement of a band of biological tissue (AlloDerm) placed 6 cm from the gastroesophageal junction. The results were compared to 54 patients with a Roux-en-Y gastric bypass (GBP), matched for sex, age, and initial body mass index.


RESULTS
All 27 patients had improvement or resolution of their diabetes, hypertension, hyperlipidemia, and sleep apnea after banded sleeve gastrectomy (BSG) similar to the control GBP group. There were no deaths, but one patient had a pulmonary embolus and another had a presumed leak. Symptoms of gastroesophageal reflux disease generally improved. Overall, results were almost identical to patients with GBP.


CONCLUSIONS
BSG provides results comparable to GBP in the short-term follow-up, but avoids potential long-term complications including internal hernias, postoperative bowel obstructions, anastomotic complications of the jejunojejunostomy, hypoglycemia, bacterial overgrowth, and a spectrum of malabsorptive problems. While this study documents the feasibility and possible benefits of this modification, prospective controlled studies with long-term follow-up are needed to establish its place in procedures for surgical weight loss.
Alexander
J Wesley
JW
Center for Surgical Weight Loss, Department of Surgery, College of Medicine, University of Cincinnati, Cincinnati, OH, USA. jwesley.alexander@uc.edu
Martin Hawver
Lisa R
LR
Goodman
Hope R
HR
D000293:Adolescent; D000328:Adult; D015992:Body Mass Index; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects; D015390:Gastric Bypass / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000453:epidemiology*; D016896:Treatment Outcome; D015431:Weight Loss / Q000502:physiology*; D055815:Young Adult