Existe-t-il des facteurs prédictifs de succès dans le traitement de l'obésité morbide par anneau périgastrique modulable ? Étude prospective

Abstract

Background. – Surgical treatment of morbid obesity by perigastric adjustable banding give at mid term follow up, contrasted results which associate succes, failure and intermediate situations. Aims. – The objective of this work was to prospectively validate predicting items that would predict success in the surgical treatment of morbid obesity by adjustable gastric banding. Material and methods. – Eighty patients with morbid obesity have been treated with adjustable gastric banding. Seventy one women, and nine men with a mean age of 37.8 years (20–59) with a mean follow up of 17 months (12–52). They have been classified in three groups: success, failure, and intermediate results. Uni- and multivariate analysis was performed on six criterions: age, sex, professional activity, metabolic disorders, lengh of obesity and body mass index (BMI). Results. – Concerning age, sex, professional activity, metabolic disorders, and lengh of obesity, there was no difference between the three groups. However, a BMI more than 50 kg/m 2 has a strong predictive value. Patients called "super obese: BMI >50 has a high rate of failure (64%) even the weight loss is ofen important in absolute value, but the BMI a the follow up remain high and more than 40. In this situation: gastric banding does not seem a good treatment because it does not protect these patients against the lethal risk of their comorbidities. Conclusion. – In this study, there is not a specific candidate « profile » to a successful treatment of morbid obesity by adjustable gastric banding. Meanwhile the initial BMI appear to be a predictive factor of success or failure. In the case of patients with high BMI >50 (super obese) Gastric banding did not seen to be a good treatment and an other technical approach (gastric by pass) must be discuss.