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Outcomes of Roux-en-Y gastric bypass and laparoscopic adjustable gastric banding.
- Source :
-
World journal of gastroenterology [World J Gastroenterol] 2013 Sep 28; Vol. 19 (36), pp. 6035-43. - Publication Year :
- 2013
-
Abstract
- Aim: To evaluate weight loss and surgical outcomes of Roux-en-Y gastric bypass (RYGB) and laparoscopic adjustable gastric band (LAGB).<br />Methods: Data relating to changes in body mass index (BMI) and procedural complications after RYGB (1995-2009; n = 609; 116M: 493F; 42.4 ± 0.4 years) or LAGB (2004-2009; n = 686; 131M: 555F; 37.2 ± 0.4 years) were extracted from prospective databases.<br />Results: Pre-operative BMI was higher in RYGB than LAGB patients (46.8 ± 7.1 kg/m² vs 40.4 ± 4.2 kg/m², P < 001); more patients with BMI < 35 kg/m² underwent LAGB than RYGB (17.1% vs 4.1%, P < 0.0001). BMI decrease was greater after RYGB. There were direct relationships between weight loss and pre-operative BMI (P < 0.001). Although there was no difference in weight loss between genders during the first 3-year post-surgery, male LAGB patients had greater BMI reduction than females (-8.2 ± 4.3 kg/m² vs -3.9 ± 1.9 kg/m², P = 0.02). Peri-operative complications occurred more frequently following RYGB than LAGB (8.0% vs 0.5%, P < 0.001); majority related to wound infection. LAGB had more long-term complications requiring corrective procedures than RYGB (8.9% vs 2.1%, P < 0.001). Conversion to RYGB resulted in greater BMI reduction (-9.5 ± 3.8 kg/m²) compared to removal and replacement of the band (-6.0 ± 3.0 kg/m²). Twelve months post-surgery, fasting glucose, total cholesterol and low density lipoprotein levels were significantly lower with the magnitude of reduction greater in RYGB patients.<br />Conclusion: RYGB produces substantially greater weight loss than LAGB. Whilst peri-operative complications are greater after RYGB, long-term complication rate is higher following LAGB.
- Subjects :
- Adult
Biomarkers blood
Blood Glucose metabolism
Body Mass Index
Chi-Square Distribution
Cholesterol blood
Comorbidity
Female
Gastrointestinal Diseases etiology
Gastrointestinal Diseases surgery
Humans
Kaplan-Meier Estimate
Lipoproteins, LDL blood
Male
Obesity blood
Obesity diagnosis
Reoperation
Risk Factors
Sex Factors
Surgical Wound Infection etiology
Surgical Wound Infection surgery
Time Factors
Treatment Outcome
Gastric Bypass adverse effects
Laparoscopy adverse effects
Obesity surgery
Weight Loss
Subjects
Details
- Language :
- English
- ISSN :
- 2219-2840
- Volume :
- 19
- Issue :
- 36
- Database :
- MEDLINE
- Journal :
- World journal of gastroenterology
- Publication Type :
- Academic Journal
- Accession number :
- 24106404
- Full Text :
- https://doi.org/10.3748/wjg.v19.i36.6035