title: Laparoscopic adjustable gastric banding versus Roux-en-Y gastric bypass: 10-year results of a prospective, randomized trial.
abstract: BACKGROUND
  There are few studies of long-term outcomes for either laparoscopic adjustable gastric banding (LAGB) or laparoscopic Roux-en-Y gastric bypass (LRYGB). The objective of this study was to compare outcomes of patients randomly assigned to undergo LAGB or LRYGB at 10 years.
  
  
  METHODS
  LAGB, using the pars flaccida technique, and standard LRYGB were performed. From January 2000 to November 2000, 51 patients (mean age 34.0 ± 8.9 years; range 20-49) were randomly allocated to undergo either LAGB (n = 27, 5 men and 22 women; mean age 33.3 years; mean weight 120 kg; mean body mass index [BMI] 43.4 kg/m(2)) or LRYGB (n = 24, 4 men and 20 women; mean age 34.7; mean weight 120 kg; mean BMI 43.8 kg/m(2)). Data on complications, reoperations, weight, BMI, percentage of excess weight loss, and co-morbidities were collected yearly. The data were analyzed using Student's t test and Fisher's exact test, with P<.05 considered significant.
  
  
  RESULTS
  Five patients in the LAGB group and 3 patients in the LRYGB group were lost to follow-up. No patient died. Conversion to laparotomy was performed in 1 (4.2%) of 24 LRYGB patients. Reoperations were required in 9 (40.9%) of 22 LAGB patients and in 6 (28.6%) of the 21 LRYGB patients. At 10-year follow-up, the LRYGB patients had a greater percentage of mean excess weight loss than did the LAGB patients (69±29% versus 46±27%; P = .03).
  
  
  CONCLUSIONS
  LRYGB was superior to LAGB in term of excess weight loss results (76.2% versus 46.2%) at 10 years. However, LRYGB exposes patients to higher early complication rates than LAGB (8.3% versus 0%) and potentially lethal long-term surgical complications (internal hernia and bowel obstruction rate: 4.7%).
authors: General and Laparoscopic Surgery Unit, S. Giovanni Bosco Hospital, Naples, Italy. luigiangrisani@chirurgiaobesita.it
authors: Luigi
authors: L
authors: Angrisani
authors: Pier Paolo
authors: PP
authors: Cutolo
authors: Giampaolo
authors: G
authors: Formisano
authors: Gabriella
authors: G
authors: Nosso
authors: Giuliana
authors: G
authors: Vitolo
mesh_terms: D000328:Adult; D015992:Body Mass Index; D005260:Female; D005500:Follow-Up Studies; D015390:Gastric Bypass / Q000379:methods*; D015391:Gastroplasty / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology; D011446:Prospective Studies; D012086:Reoperation / Q000706:statistics & numerical data; D015431:Weight Loss / Q000502:physiology; D055815:Young Adult