title: 5-year outcomes of 1-stage gastric band removal and sleeve gastrectomy.
abstract: BACKGROUND
  No verdict has been reached on single-stage removal of gastric banding with sleeve gastrectomy.
  
  
  OBJECTIVE
  To report 5-year outcomes of 1-stage gastric band removal and sleeve gastrectomy (Conversion-LSG) compared with primary laparoscopic sleeve gastrectomy (Prim-LSG).
  
  
  METHODS
  Large single-surgeon prospective database.
  
  
  METHODS
  Two patient groups were included: Conversion-LSG as the study group and Prim-LSG for comparison. Preconversion characteristics, conversion indication, weight loss, and complications were compared. The surgical protocol was reviewed, focusing on key technical recommendations.
  
  
  RESULTS
  A total of 209 Conversion-LSG and 3268 Prim-LSG patients, aged 32.9±9.8 and 31.8±10.7 years respectively (P = .2), were studied. No significant differences in age, body mass index (BMI), or gender distribution existed. Conversion-LSG Baseline BMI was 47±12 kg/m2. Patients spent 6.2±2.6 years with the band before Conversion-LSG. BMI at 1, 2, 3, 4, and 5 years was 37±8, 31±9, 29±11, 30±9, and 30±11 kg/m2, respectively. No significant difference in BMI change between the 2 groups existed. In the Conversion-LSG group, 1 patient had a successfully stented leak but developed a gastrobronchial fistula 1 year later. In the Prim-LSG group, 3 leak cases were reported and managed successfully through endoscopic stenting, 1 patient had pulmonary embolism that responded to standard treatment, and 3 patients had postoperative bleeding. No other major complications occurred, and there was no mortality in either group. Additionally, no Conversion-LSG patients required further bariatric intervention.
  
  
  CONCLUSIONS
  Employing the surgical technique described in this paper, conversion-LSG is as well tolerated and effective as primary sleeve gastrectomy.
authors.affiliation: Department of Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia. Electronic address: qahtani@yahoo.com.
authors.forename: Aayed R
authors.initials: AR
authors.lastname: Alqahtani
authors.affiliation: Department of Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Mohamed O
authors.initials: MO
authors.lastname: Elahmedi
authors.affiliation: Department of Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Awadh R
authors.initials: AR
authors.lastname: Al Qahtani
authors.affiliation: Department of Surgery, New You Medical Center, Riyadh, Saudi Arabia.
authors.forename: Ahmad
authors.initials: A
authors.lastname: Yousefan
authors.affiliation: Department of Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Ahmed R
authors.initials: AR
authors.lastname: Al-Zuhair
mesh_terms: D000328:Adult; D015992:Body Mass Index; D020878:Device Removal / Q000379:methods; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects*; D015391:Gastroplasty / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D008297:Male; D009767:Obesity, Morbid / Q000601:surgery*; D011446:Prospective Studies; D012086:Reoperation; D016896:Treatment Outcome; D015431:Weight Loss
keywords: Band removal; Concomitant; Gastric band; One-stage; Revision; Single-stage; Sleeve gastrectomy