title: Laparoscopic Adjustable Gastric Banding (LAGB) Plus Anterior Fundoplication Versus LAGB Alone: A Prospective Comparative Study.
abstract: BACKGROUND
  Laparoscopic adjustable gastric banding (LAGB) is a well-established and effective bariatric procedure, whose outcomes can be compromised by the slippage and the following removal of the band; the association between LAGB and gastric plication has recently been proved as a successful treatment for morbid obesity. The aim of this prospective randomized study was to compare weight loss and slippage rate between LAGB and LAGB plus anterior fundoplication.
  
  
  METHODS
  From January 2012 to May 2012, a total of 40 patients were allocated to undergo either LAGB (group A, n=20) or LAGB plus anterior fundoplication (group B, n=20). Data on the operative time, complications, hospital stay, total weight loss percentage (%TWL), percentage of excess weight loss (%EWL), and improvement of comorbidities were collected at 6, 12, and 36 months of follow-up.
  
  
  RESULTS
  All procedures were completed laparoscopically, and no significant difference of mean operative time was found between the 2 groups. The mean hospital stay was longer in group B than in group A (2.3±0.8 vs. 1.4±0.7 d, P<0.005). Greater weight loss was found in group B rather than in group A at 6, 12, and 36 months. Obesity related comorbidities improved in both groups. Number of band regulations and slippage rate were lower in group B.
  
  
  CONCLUSIONS
  Our experience shows that 36 months after surgery LAGB plus anterior fundoplication increases weight loss and reduces the slippage rate.
authors.affiliation: *Department of Medicine and Surgery, University Hospital of Salerno, Salerno †Department of Endocrinology, Gastroenterology and Surgery, University Hospital of Naples "Federico II," Naples, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Pilone
authors.forename: Antonio
authors.initials: A
authors.lastname: Vitiello
authors.forename: Angela
authors.initials: A
authors.lastname: Monda
authors.forename: Francesco
authors.initials: F
authors.lastname: Giglio
authors.forename: Pietro
authors.initials: P
authors.lastname: Forestieri
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D018662:Fundoplication / Q000009:adverse effects / Q000379:methods*; D015391:Gastroplasty / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D061646:Operative Time; D011183:Postoperative Complications / Q000209:etiology; D011446:Prospective Studies; D012086:Reoperation; D016896:Treatment Outcome; D015431:Weight Loss / Q000502:physiology; D055815:Young Adult