title: A Comparative, Prospective and Randomized Evaluation of Roux-en-Y Gastric Bypass With and Without the Silastic Ring: A 2-Year Follow Up Preliminary Report on Weight Loss and Quality of Life.
abstract: BACKGROUND
  Currently, Roux-en-Y gastric bypass (RYGB) is one of the most widely used bariatric surgeries. Banding the pouch forms a banded gastric bypass operation, an accepted and frequently used variant. Placing a silastic ring around the pouch to band the gastric bypass operation increases the restriction mechanism. However, the ubiquitous use of the banded gastric bypass remains controversial. One of the controversies is the effect of the silastic ring on patients' perception of their well being after surgery because of the frequency of vomiting. A prospective, blindly randomized, comparative trial was undertaken to resolve this controversy.
  
  
  METHODS
  Four hundred subjects scheduled for gastric bypass surgery were randomized into two arms of the trial, 200 with a silastic ring (WR) and 200 without (NR). After 2-year follow-up, the variables associated with the scores of Bariatric Analysis and Reporting Outcome System (BAROS) were analyzed.
  
  
  RESULTS
  The initial median weight (125 kg), BMI (47), and age (36 years) were the same in both the NR and WR groups. The median excess weight loss, weight regain, and incidence of vomiting were 71, 10.5, and 7.75%, respectively, in the NR group vs. 75.4 and 1.1, and 24.4% in the WR group. The mean QOL score was 79% in the NR group vs. 80% in the WR group.
  
  
  CONCLUSIONS
  After 2-year follow-up, silastic ring placement in the RYGB resulted in greater weight loss and weight stability and a threefold greater incidence of vomiting. There was no difference in the scores in the quality of life analysis.
authors: Department of Surgery and Orthopedics, Botucatu Medical School-UNESP, Av. Brasil, 1034, 13416-530, Piracicaba, S.P, Brazil. irineu@bariatrica.com.br.
authors: I
authors: I
authors: Rasera
authors: Piracicaba Bariatric Clinic/SP, Piracicaba, Brazil.
authors: T H
authors: TH
authors: Coelho
authors: School of Pharmaceutical Sciences of Araraquara-UNESP, Araraquara, Brazil.
authors: M N
authors: MN
authors: Ravelli
authors: School of Pharmaceutical Sciences of Araraquara-UNESP, Araraquara, Brazil.|Bioscience Institute at UNESP-Botucatu, Botucatu, Brazil.
authors: M R M
authors: MR
authors: Oliveira
authors: Department of Surgery and Orthopedics, Botucatu Medical School-UNESP, Av. Brasil, 1034, 13416-530, Piracicaba, S.P, Brazil.
authors: C V S
authors: CV
authors: Leite
authors: Department of Surgery and Orthopedics, Botucatu Medical School-UNESP, Av. Brasil, 1034, 13416-530, Piracicaba, S.P, Brazil.
authors: L E
authors: LE
authors: Naresse
authors: Department of Surgery and Orthopedics, Botucatu Medical School-UNESP, Av. Brasil, 1034, 13416-530, Piracicaba, S.P, Brazil.
authors: M A C A
authors: MA
authors: Henry
mesh_terms: D000328:Adult; D004129:Dimethylpolysiloxanes; D005260:Female; D005500:Follow-Up Studies; D015390:Gastric Bypass / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery; D011446:Prospective Studies; D019736:Prostheses and Implants; D011788:Quality of Life; D014839:Vomiting / Q000209:etiology*; D015431:Weight Loss; D055815:Young Adult
chemical_list: D004129:Dimethylpolysiloxanes; C013830:baysilon
keywords: Bariatric surgery; Gastric bypass; Morbid obesity; Postoperative complications; Quality of life; Silastic ring; Weight loss