title: Is there a relation between number of adjustments and results after gastric banding?
abstract: BACKGROUND
  Laparoscopic adjustable gastric banding (LAGB) is a standard restrictive bariatric procedure. Previous studies have shown that patients lost to follow-up do worse than patients who remain in follow-up. However, it is unknown if this is purely because of a lack of band adjustments. The aim of this study was to study the relation between number of adjustments and results.
  
  
  METHODS
  Patients who underwent primary LAGB from October 2006 until March 2009 were included. The following parameters were collected: demographic characteristics, preoperative and postoperative weight, preoperative and postoperative status of co-morbidities, type of band, short- and long-term complications, reoperations, date, number and volume of adjustments, total amount of inserted volume, and last measured volume.
  
  
  RESULTS
  One hundred seventy-four patients underwent primary LAGB. Twelve patients did not attend follow-up visits after 24 months (8.1%). Mean follow-up was 46 months, and excess weight loss, 47%. Eleven patients (8.1%) developed long-term complications, and 12 patients (8.8%) underwent revisional surgery. Patients underwent a mean number of 5 adjustments with a range of 0 to 18. The mean volume of totally inserted milliliters was 8 mL, with a range of 0 to 14 mL. There was a strong positive relation between number of adjustments and weight loss as well as reduction in obesity-related co-morbidities (r = .22; P<.01). There was no significant relation between number of adjustments and complications or revisional surgery.
  
  
  CONCLUSIONS
  There is a strong relation between the number of band adjustments and weight loss, whereas complications and reoperations seem to be independent of the number of adjustments. A continual and lifelong follow-up of LAGB patients, including regular band volume adjustments, is necessary.
authors.affiliation: Bariatric Centre Lievensberg Hospital, Bergen op Zoom, The Netherlands. Electronic address: schoutenruben@hotmail.com.
authors.forename: Ruben
authors.initials: R
authors.lastname: Schouten
authors.forename: Gerhard
authors.initials: G
authors.lastname: van 't Hof
authors.forename: Pierre B
authors.initials: PB
authors.lastname: Feskens
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D015391:Gastroplasty / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D015994:Incidence; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods*; D009767:Obesity, Morbid / Q000175:diagnosis / Q000601:surgery*; D011183:Postoperative Complications / Q000175:diagnosis / Q000601:surgery; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D018570:Risk Assessment; D013997:Time Factors; D016896:Treatment Outcome
keywords: Adjustments; Band volume; Gastric banding; Results