title: Laparoscopic Adjustable Gastric Banding: Predictive Factors for Weight Loss and Band Removal After More than 10 Years' Follow-Up in a Single University Unit.
abstract: Weight loss and overall outcomes following laparoscopic adjustable gastric banding (LAGB) are more variable than with other bariatric procedures. Our aim was to investigate the predictive value of certain parameters in a cohort of 794 patients with 10 years' minimum follow-up after LAGB.
  
  
  
  We retrospectively reviewed the records of 794 patients undergoing LAGB performed by the authors between April 1996 and December 2004. We collected patients' data on weight loss and band-related complications and performed logistic regression modelling and calculated Kaplan-Meier curves for band preservation.
  
  
  
  The follow-up rate at 10 years was 90.4%. The mean follow-up duration was 15.1 years (range, 120-228 months). Overall band removal with or without conversion or replacement was required in 304 (38.2%) patients. The mean survival time of the band was 148.4 months (95% confidence interval: 138.3-167.4), and there was no difference in the rate of removal by operative technique (p = 0.7). The highest rate of band removal occurred in female patients (p = 0.05), those with BMI > 50 kg/m2(p = 0.005) and in those <40 years of age (p = 0.04). For patients with the band in situ, the success rate was significantly lower in patients with initial BMI > 50 kg/m2. Conversely, differences in success rate were not statistically significant for age (using 50 years as the cut-off), technique or sex.
  
  
  
  Higher rates of removal occurred in women, younger patients and those with BMI > 50 kg/m2. Regardless of these criteria, the rate of band removal for complications rose over time. Patients should be informed of the high risk of the need for band removal long-term.
authors.affiliation: Department of General and Digestive Surgery, University Hospital Bichat Claude Bernard, 46 rue Henri Huchard, Paris, 75877, Paris CEDEX 18, France.
authors.forename: Pasquale
authors.initials: P
authors.lastname: Tammaro
authors.affiliation: Team of Diabetes Vascular Complication Cordelier Recherche Center, Department of Diabetes, Nutrition Bichat-Claude Bernard University Hospital, Paris, France.
authors.forename: Boris
authors.initials: B
authors.lastname: Hansel
authors.affiliation: Department of General and Digestive Surgery, University Hospital Bichat Claude Bernard, 46 rue Henri Huchard, Paris, 75877, Paris CEDEX 18, France.
authors.forename: Andrea
authors.initials: A
authors.lastname: Police
authors.affiliation: Centre of Recherche of Psychanalysis, Medecine and Society, University of Paris VII, 5 rue Thomas-Mann, Paris, 75205, Paris Cedex 13, France.
authors.forename: Marina
authors.initials: M
authors.lastname: Kousouri
authors.affiliation: Team REGLYS University of Paris-CNRS UMR8251, Bâtiment Buffon, 3ème étage, pièce 340A, case courrier 7126, 4 rue Marie Andrée Lagroua Weill-Halle, Paris, France.
authors.forename: Christophe
authors.initials: C
authors.lastname: Magnan
authors.affiliation: Department of General and Digestive Surgery, University Hospital Bichat Claude Bernard, 46 rue Henri Huchard, Paris, 75877, Paris CEDEX 18, France.
authors.forename: Jean Pierre
authors.initials: JP
authors.lastname: Marmuse
authors.affiliation: Department of General and Digestive Surgery, University Hospital Bichat Claude Bernard, 46 rue Henri Huchard, Paris, 75877, Paris CEDEX 18, France. konstarapis@hotmail.com.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Arapis
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015992:Body Mass Index; D020878:Device Removal; D005260:Female; D005500:Follow-Up Studies; D015391:Gastroplasty / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000503:physiopathology / Q000601:surgery*; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D016896:Treatment Outcome; D015431:Weight Loss; D055815:Young Adult