Effectiveness and Safety of Sleeve Gastrectomy, Gastric Bypass, and Adjustable Gastric Banding in Morbidly Obese Patients: a Multicenter, Retrospective, Matched Cohort Study
| Autor: | Bark Betzel, Ralph P. M. Gadiot, Kemal Dogan, L. U. Biter, Theo J. Aufenacker, Frits J. Berends, Ignace M. C. Janssen, Guido H. H. Mannaerts, Cees J. H. M. van Laarhoven, Edo O. Aarts |
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| Rok vydání: | 2015 |
| Předmět: |
Adult
Male Reoperation medicine.medical_specialty Sleeve gastrectomy Gastroplasty Endocrinology Diabetes and Metabolism medicine.medical_treatment Gastric Bypass Cohort Studies Tumours of the digestive tract Radboud Institute for Health Sciences [Radboudumc 14] Matched cohort Gastrectomy Weight loss Weight Loss Humans Medicine Adjustable gastric band Retrospective Studies Nutrition and Dietetics business.industry General surgery Case-control study Retrospective cohort study Length of Stay Middle Aged Obesity Morbid Surgery Clinical trial Renal disorders Radboud Institute for Molecular Life Sciences [Radboudumc 11] Treatment Outcome Case-Control Studies Female Laparoscopy medicine.symptom business Cohort study |
| Zdroj: | Obesity Surgery, 25, 1110-8 Obesity Surgery, 25, 7, pp. 1110-8 |
| ISSN: | 0960-8923 |
| Popis: | Contains fulltext : 155130.pdf (Publisher’s version ) (Closed access) BACKGROUND: Laparoscopic adjustable gastric band (LAGB), laparoscopic sleeve gastrectomy (LSG), and laparoscopic Roux-en-Y gastric bypass (LRYGB) are the most performed procedures worldwide (92 %) nowadays. However, comparative clinical trials are scarce in literature. The objective of this study was to compare the effectiveness and safety of the three most performed bariatric procedures. METHODS: A multicenter, retrospective, matched cohort study was conducted. Patients were eligible for analysis when a primary procedure was performed between 2007 and 2010 in one of the two specialized bariatric centers. Primary outcome was weight loss, expressed in the percentage excess weight loss (%EWL). Secondary outcome parameters are hospital stay, complication rate, and revisional surgery. RESULTS: In total, 735 patients, 245 in each group, were included for analysis. The groups were comparable for age and gender after matching. Mean postoperative follow-up was 3.1 +/- 1.2 years. LAGB patients showed less %EWL compared to LSG and LRYGB at all postoperative follow-up visits. LRYGB showed a %EWL of 71 +/- 20 % compared to LSG (76 +/- 23 %; p = 0.008) after 1-year follow-up; thereafter, no significant difference was observed. After 3 years of follow-up, LAGB showed a higher complication rate compared to LSG and LRYGB (p < 0.05). Revisional surgery after LAGB was needed in 21 %, while 9 % of the LSG underwent conversion to RYGB. CONCLUSIONS: LRYGB is a safe and effective treatment in morbid obese patients with good long-term outcomes. LSG seems to be an appropriate alternative as a definitive procedure, in terms of weight reduction and complication rate. LAGB is inferior to both LRYGB and LSG. |
| Databáze: | OpenAIRE |
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