title: Long-term outcomes of laparoscopic adjustable silicone gastric banding (LAGB) in moderately obese patients with and without co-morbidities.
abstract: BACKGROUND
  Overweight and obesity independently increase cardiovascular risk, while even modest weight loss can result in clinically significant improvements in cardiovascular risk and reduce long-term mortality. Lowering the body mass index (BMI) threshold for bariatric surgery to those with moderate obesity might be one way to lower the burden of this disease. The aim of this study was to evaluate the efficacy and safety of laparoscopic adjustable silicone gastric banding (LAGB) in moderately obese subjects with or without obesity-related co-morbidities.
  
  
  METHODS
  Thirty-four patients with BMI between 30 and 35 kg/m(2) (5 males/29 females, mean age 36 ± 10 years, mean preoperative weight 87.9 ± 7.1 kg, mean BMI 32.6 ± 1.6 kg/m(2) and mean percentage excess weight 48.7 ± 9 %) who underwent LAGB via pars flaccida between June 1, 2002 and August 31, 2010 were included. Good response was defined as BMI <30 kg/m(2) or percentage estimated weight loss (%EWL) >50. Poor response was defined as BMI >30 kg/m(2) or %EWL less than 50 after a minimum of 1 year.
  
  
  RESULTS
  Mean weight, BMI and %EWL were recorded at 1, 3, 5 and 7 years and were 77.4 ± 7.6, 69.9 ± 10.8, 70.9 ± 9.3 and 73.3 ± 12.0 kg; 28.8 ± 2.9, 26.4 ± 3.2, 26.5 ± 3.4 and 27.4 ± 5.0 kg/m(2); and 36 ± 23, 46.1 ± 33.8, 58.6 ± 31.5 and 45 ± 57, respectively (p < 0.01). Co-morbidities were diagnosed in 17/34 (50 %) patients at baseline and underwent remission or improvement in all cases after 1 year.
  
  
  CONCLUSIONS
  LAGB in a safe and effective procedure in patients with a BMI <35 kg/m(2).
authors.affiliation: General and Endoscopic Surgery Unit, S.Giovanni Bosco Hospital, ASL NA1 Centro, via S.Lucia 143, 80132, Napoli, Italy. luigiangrisani@chirurgiaobesita.it
authors.forename: Luigi
authors.initials: L
authors.lastname: Angrisani
authors.forename: Pier Paolo
authors.initials: PP
authors.lastname: Cutolo
authors.forename: Giampaolo
authors.initials: G
authors.lastname: Formisano
authors.forename: Gabriella
authors.initials: G
authors.lastname: Nosso
authors.forename: Antonella
authors.initials: A
authors.lastname: Santonicola
authors.forename: Giuliana
authors.initials: G
authors.lastname: Vitolo
mesh_terms: D000328:Adult; D015992:Body Mass Index; D001835:Body Weight; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D015391:Gastroplasty / Q000379:methods; D006801:Humans; D007558:Italy / Q000453:epidemiology; D010535:Laparoscopy / Q000379:methods; D008297:Male; D009765:Obesity / Q000453:epidemiology / Q000601:surgery*; D018579:Patient Selection; D012307:Risk Factors; D012720:Severity of Illness Index; D012828:Silicones; D013997:Time Factors; D016896:Treatment Outcome; D015431:Weight Loss
chemical_list: D012828:Silicones