title: Rejecting the demise of vertical-banded gastroplasty: a long-term single-institute experience.
abstract: Surgical interventions have proven to be more effective than other measures in the treatment of morbid obesity. The short-term outcomes of the various surgical interventions have been well documented in the literature, with fewer reports on long-term outcomes. The reported long-term outcome of the vertical-banded gastroplasty (VBG) is conflicting. The aim of the present study was to evaluate our long-term experience with VBG. A retrospective review of a prospectively maintained database was conducted. Records of patients who underwent VBG five or more years ago were retrieved. An analysis of the long-term weight changes and reported complications was conducted. The study included 150 patients: 43 males (29%) and 107 females (71%). Their mean age was 30 years old (12-53), and the mean body mass index (BMI) was 47 ± 8.4 kg/m2. Patients were followed up for an average of 8 years (5-11). More than 60 % of patients had good long-term weight loss (EWL > 50%). A significant negative correlation was found between the excess weight loss percent (EWL%) and the pre-operative BMI (p < 0.05). The differences in EWL% between males and females were not significant (p = 0.061). Nevertheless, the change in EWL% over time for both males and females was significant (p = 0.004). Revision surgery was required in seven patients (4.7%). Five patients had conversion of VBG to gastric bypass (3.3%), while two patients (1.3%) had reversal of the procedure. Late complications included mesh erosion in three cases, staple line dehiscence in two patients, and stomal stenosis in six patients. VBG could be a long-term effective intervention for the treatment of morbid obesity. Good selection is the cornerstone for long-term success. Late complication rate is acceptable after VBG. VBG is a specifically useful tool under stringent financial circumstances.
authors: HBP Surgery Unit, Department of Surgery, Faculty of medicine, Alexandria Main University Hospital, Alexandria, Egypt, dr_mohamedbekheit@hotmail.com.
authors: Mohamed
authors: M
authors: Bekheit
authors: Khaled
authors: K
authors: Katri
authors: Wael Nabil Abdel
authors: WN
authors: Salam
authors: Tarek
authors: T
authors: Ezzat
authors: El Said
authors: el S
authors: El Kayal
mesh_terms: D000293:Adolescent; D000328:Adult; D015992:Body Mass Index; D002648:Child; D004534:Egypt / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D015391:Gastroplasty / Q000592:standards / Q000706:statistics & numerical data / Q000639:trends; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000453:epidemiology / Q000601:surgery*; D018579:Patient Selection; D011183:Postoperative Complications / Q000453:epidemiology*; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012737:Sex Factors; D013997:Time Factors; D016896:Treatment Outcome; D015431:Weight Loss
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