title: Multidisciplinary approach to morbidly obese patients undergoing surgical treatment by adjustable gastric banding.
abstract: OBJECTIVE
  To evaluate the outcome of the surgical treatment of morbidly obese patients by Adjustable Gastric Banding (ABG) followed in a multidisciplinary clinic.
  
  
  METHODS
  We studied 20 patients with BMI ranging from 36.6 to 72 kg/m2 (X = 47.51 + / - 6.1) and aged between 36 to 60 years, undergoing placement of AGB. Preoperative comorbidities were hypertension (nine), type II diabetes (four), severe sleep apnea (one), hypertriglyceridemia (four) and severe orthopedic problems (three). In the post-operative period patients were followed at a multidisciplinary clinic (surgeon, endocrinologist, psychiatrist and nutritionist). In the first six months, the orientation was of monthly visits for band adjustments and nutritional counseling. After six months the visits occurred every two or three months, as needed.
  
  
  RESULTS
  The operative time ranged from 40 to 180 minutes; hospital stay varied from one to ten days (X = 36 hours). Two patients required surgical reintervention for late complications: a rotation of the portal and a band superior slippage. Follow-up ranged from 28 to 36 months. The average weight loss was 29.26 kg +/- 8.8, or 24.37% +/- 6.1 of the original weight and 49.16% +/- 11.3 overweight. The average BMI ranged from 47.51 to 34.88. There was global improvement of comorbidities, markedly in the patients with greater weight loss.
  
  
  CONCLUSIONS
  The results were satisfactory for most patients on the variables weight loss and improvement of comorbidities.
authors.affiliation: Departamento de Gastroenterologia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil. pajecki@netpoint.com.br
authors.forename: Denis
authors.initials: D
authors.lastname: Pajecki
authors.forename: Marcio C
authors.initials: MC
authors.lastname: Mancini
authors.forename: Alfredo
authors.initials: A
authors.lastname: Halpern
authors.forename: Bruno
authors.initials: B
authors.lastname: Zilberstein
authors.forename: Artur B
authors.initials: AB
authors.lastname: Garrido
authors.forename: Ivan
authors.initials: I
authors.lastname: Cecconello
mesh_terms: D000328:Adult; D005260:Female; D015391:Gastroplasty; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D010348:Patient Care Team; D055815:Young Adult