title: A decade of bariatric surgery. What have we learned? Outcome in 520 patients from a single institution.
abstract: BACKGROUND
  Today a variety of bariatric surgical procedures is available and, currently, it is difficult to identify the most effective option based on patient characteristics and comorbidities. Aim of this retrospective study is to evaluate the efficacy of four different techniques; Intragastric Balloon (IB), Laparoscopic Adjustable Gastric Banding (LAGB), Laparoscopic Sleeve Gastrectomy (LSG) and Laparoscopic Mini Gastric Bypass (LMGB), performed in our unit along ten years.
  
  
  METHODS
  Starting from January 2005, 520 patients, 206 men (39.6%) and 314 women (60.4%) were treated at our institution. Among patients candidate to bariatric surgery 145 underwent IB, 120 underwent LAGB, 175 underwent LSG and 80 underwent LMGB. Follow up rate was 93.1% for IB at 6 months; 74.1% and 48% for LAGB at 36 and 60 months respectively; 72.8% and 58.1% for LSG at 36 and 60 months respectively; and 84.2% for LMGB at 36 months.
  
  
  RESULTS
  The period 2005-2014 has been considered. Mortality was 1/520 patients (0.19%). The excess weight loss rate (EWL%) has been 32.8 for IB at six months, 53.7 for LAGB and 68.1 for LSG, at 60 months respectively and 79.5 for LMGB at 36 months. Early major postoperative complications requiring surgery were 0.6% for IB and 1.1% for LSG whereas late major postoperative complications were 1.2% for IB, 4.1% for LAGB and 0.5% for LSG. Diabetes resolution rate was 0 for LAGB, 76.9% for LSG and 80% for LMGB at 36 months.
  
  
  CONCLUSIONS
  If more invasive procedures as LSG or LMGB may entail higher operative and peroperative risks, conversely, in skilled hands their efficacy remains undisputed, especially in the long term, presenting a very low rate of major complications. In general, the efficacy of a bariatric surgery unit seems improved by the capability to offer both different primary procedures and re-do surgery.
authors.affiliation: "Federico II" University, Medical School, Advanced Biomedical Sciences Department - General Surgery, Italy. Electronic address: mario.musella@unina.it.
authors.forename: M
authors.initials: M
authors.lastname: Musella
authors.affiliation: "Federico II" University, Medical School, Advanced Biomedical Sciences Department - General Surgery, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Milone
authors.affiliation: "Federico II" University, Medical School, Advanced Biomedical Sciences Department - General Surgery, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Gaudioso
authors.affiliation: "Federico II" University, Medical School, Advanced Biomedical Sciences Department - General Surgery, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Bianco
authors.affiliation: "Federico II" University, Medical School, Advanced Biomedical Sciences Department - General Surgery, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Palumbo
authors.affiliation: Clinical Medicine and Surgery Department - Surgical Endoscopy, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Galloro
authors.affiliation: "Federico II" University, Medical School, Advanced Biomedical Sciences Department - General Surgery, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Bellini
authors.affiliation: "Federico II" University, Medical School, Advanced Biomedical Sciences Department - General Surgery, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Milone
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D050110:Bariatric Surgery / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D010535:Laparoscopy / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D015996:Survival Rate; D015431:Weight Loss / Q000502:physiology*; D055815:Young Adult
keywords: Bariatric surgery; Intragastric balloon; Laparoscopic adjustable gastric banding; Laparoscopic mini gastric bypass; Laparoscopic sleeve gastrectomy; Outcome