title: Is Gastric Banding Appropriate in Indigenous Or Remote-Dwelling Persons?
abstract: Gastric banding has been promoted as less suitable for indigenous persons or persons who live remotely as it requires in person follow-up for band adjustment and may have higher rates of reoperation. This study assessed being an indigenous Australian or living remotely (but not both) on outcomes following gastric banding.
  
  
  
  Data was prospectively recorded on all 559 patients who underwent gastric banding by one surgeon at one private hospital in Darwin, between February 1998 and August 2014.
  
  
  
  Forty persons (7 %) were indigenous and 93 (17 %) were remotely living (only 7 were both). At the last assessment (follow-up 37 (SD 31) months), overall percentage of excess weight loss (EWL) was 53 % (30 %), the percentage of total weight loss (TWL) was 23 (13), and 389 (70 %) achieved >50 % EWL. Seventy-two percent (43/60) ceased all diabetic medications. Ninety-two (17 %) came to reoperation. There was little difference between the indigenous and non-indigenous metropolitan-living groups, or between the remote and metropolitan non-indigenous groups in %EWL, %TWL, the proportion who achieved more than 50 % EWL, the time to achieve the goal weight, or cessation of diabetes medication. Similarly, there was little difference in the time to band removal or replacement. No person was directly compromised at band removal/replacement by delay due to dwelling remotely.
  
  
  
  In these select persons who underwent gastric banding in the private sector only, outcomes of weight loss and revisional surgery were acceptable and comparable between indigenous and non-indigenous metropolitan-dwelling persons as well as between remote and metropolitan-dwelling non-indigenous persons.
authors.affiliation: Department of Surgery, Northern Territory Medical School, Flinders University, Darwin, NT, Australia. pj.treacy@bigpond.com.|, PO Box 43022, Casuarina, NT, 0811, Australia. pj.treacy@bigpond.com.
authors.forename: P John
authors.identifier: 0000-0002-7624-0591
authors.initials: PJ
authors.lastname: Treacy
authors.affiliation: Statistics Team, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia.
authors.forename: Mark D
authors.initials: MD
authors.lastname: Chatfield
authors.affiliation: Department of Surgery, Flinders Medical Centre, Adelaide, SA, Australia.
authors.forename: Justin
authors.initials: J
authors.lastname: Bessell
mesh_terms: D000328:Adult; D001315:Australia; D005260:Female; D015391:Gastroplasty / Q000706:statistics & numerical data*; D006801:Humans; D010535:Laparoscopy / Q000706:statistics & numerical data*; D008297:Male; D008507:Medically Underserved Area; D009767:Obesity, Morbid / Q000208:ethnology / Q000601:surgery*; D044382:Population Groups; D011446:Prospective Studies; D012086:Reoperation / Q000706:statistics & numerical data; D015431:Weight Loss
keywords: Bariatric surgery; Ethnicity; Gastric banding; Indigenous population; Outcome; Rural population