title: Clinical outcomes of the REALIZE adjustable gastric band-C at one year in a U.S. population.
abstract: BACKGROUND
  In 2008, the REALIZE Band (RB) adopted a precurved design (RB-C). The present study is the first multi-institutional report of RB-C outcomes. Our objective was to analyze the 1-year weight loss and safety data from adult RB-C patients treated at multiple U.S. centers (7 typical U.S. bariatric practices, including academic, nonacademic, public, and private practice).
  
  
  METHODS
  Patients implanted with the RB-C (preoperative body mass index ≥ 40 kg/m(2) or >35 kg/m(2) with co-morbidity) were recruited. The exclusion criteria included the RB-C label contraindications for use. The outcomes parameters were the percentage of excess weight loss (%EWL), change in body mass index, number and volume of band adjustments, and incidence of complications.
  
  
  RESULTS
  Of the 239 patients enrolled in the 2-year study, 158 had 1-year data available for analysis in November 2010. The mean %EWL was 39.2% ± 20.5% (range -7.7 to -116.8, P < .0001). The body mass index decreased from 44.4 ± 5.5 kg/m(2) to 36.4 ± 5.8 kg/m(2) (P < .0001). The variability in the %EWL was significant among the study centers (P < .0001). The average band fill volume at 1 year was 8.0 ± 2.0 mL (range .0-11.1). The total fill volume was >11 mL in 1 patient. No band erosions/migrations, explants, or deaths occurred.
  
  
  CONCLUSIONS
  RB-C appears to be as safe and effective as the first-generation RB. The near 40% EWL at 1 year was consistent with other high-quality publications of the RB. Good weight loss results are achievable, despite the varying postoperative management practices. The low morbidity and the absence of mortality at 12 months reflect positively on the RB-C characteristics. Our findings suggest that the learning curve, related to the postoperative management of the RB-C, might vary by practice and that a greater frequency and smaller band fills might result in better weight loss at 12 months.
authors.affiliation: Cedars-Sinai Medical Center, Los Angeles, California, USA.
authors.forename: Scott A
authors.initials: SA
authors.lastname: Cunneen
authors.forename: Collin E M
authors.initials: CE
authors.lastname: Brathwaite
authors.forename: Christopher
authors.initials: C
authors.lastname: Joyce
authors.forename: Keith
authors.initials: K
authors.lastname: Gersin
authors.forename: Keith
authors.initials: K
authors.lastname: Kim
authors.forename: Jon L
authors.initials: JL
authors.lastname: Schram
authors.forename: Erik B
authors.initials: EB
authors.lastname: Wilson
authors.forename: Claudio E
authors.initials: CE
authors.lastname: Rodriguez
authors.forename: Mario
authors.initials: M
authors.lastname: Gutierrez
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015992:Body Mass Index; D005260:Female; D015391:Gastroplasty / Q000295:instrumentation*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D019990:Perioperative Care / Q000379:methods; D011183:Postoperative Complications / Q000209:etiology; D016896:Treatment Outcome; D014481:United States; D015431:Weight Loss; D055815:Young Adult