| Popis: |
Morbid obesity causes co-morbidity such as diabetes mellitus, hypertensive heart disease, sleep apnoea, degenerative bone diseases and increased incidence of malignancy. Life expectancy and quality of life are reduced significantly. Without adequate weight loss, treatment of co-morbidity remains symptomatic only. Surgical treatment of morbid obesity is the one therapy promising long-term success, since conservative procedures normally lead to recurrence of overweight. We performed laparoscopic gastric banding on 130 patients between 1.11.95 and 31.10.97. Mean overweight was 63 +/- 12.7 kg (SD), and mean BMI was 46.5 +/- 4.6 kg/m2. The average hospital stay was 5.5 +/- 1.5 days. 4 patients with postoperative pulmonary embolism were treated with oral anticoagulation. We performed 9 (6.9%) reoperations because of pouch dilatation or dorsal slipping with food intolerance in the first series of 70, and none in the second series of 60 patients. Median weight loss after 3 months was 14.7 +/- 4.2 kg, after six months 24.0 +/- 6.6 kg and after 12 months 33.2 +/- 8.5 kg, corresponding to excessive weight loss (EWL) of 55.9 +/- 14.8% in the first year. 14 (70%) of 20 patients with diabetes mellitus normalised and 6 patients with diabetes mellitus normalised and 6 patients showed improved blood sugar levels. All 36 patients with hypertensive heart disease had normalised blood pressure, 60% of them without further medical antihypertensive treatment after median EWL of 36%. Cholesterol levels normalised in 30 (57%) patients and improved in 20 (38%) after 6 months. Laparoscopic gastric banding is a suitable method for reducing weight in morbid obesity patients and provides a better quality of life in a group of patients who are carefully evaluated and followed. Reducing co-morbidity and improving ability to work have a positive economic impact on health care costs. |
