Abstract
BackgroundObesity is a chronic relapsing-remitting disease and a global pandemic, being associated with multiple comorbidities. Laparoscopic adjustable gastric banding (LAGB) is one of the safest surgical procedures used for the treatment of obesity, and even though its popularity has been decreasing over time, it still remains an option for a certain group of patients, producing considerable weight loss and improvement in obesity-associated comorbidities.MethodsThe aim of this study was to evaluate the impact of weight loss following LAGB on obesity-associated comorbidities, and to identify factors that could predict better response to surgery, and patient sub-groups exhibiting greatest benefit. A total of 99 severely obese patients (81.2% women, mean age 44.19 ± 10.94 years, mean body mass index (BMI) 51.84 ± 8.77 kg/m2) underwent LAGB in a single institution. Results obtained 1, 2, and 5 years postoperatively were compared with the pre-operative values using SPPS software version 20.ResultsA significant drop in BMI was recorded throughout the follow-up period, as well as in A1c and triglycerides, with greatest improvement seen 2 years after surgery (51.8 ± 8.7 kg/m2 vs 42.3 ± 9.2 kg/m2, p < 0.05, 55.5 ± 19.1 mmol/mol vs 45.8 ± 13.7 mmol/mol, p < 0.05, and 2.2 ± 1.7 mmol/l vs 1.5 ± 0.6 mmol/l). Better outcomes were seen in younger patients, with lower duration of diabetes before surgery, and lower pre-operative systolic blood pressure.ConclusionsYounger age, lower degree of obesity, and lower severity of comorbidities at the time of surgery can be important predictors of successful weight loss, making this group of patients the ideal candidates for LAGB.
Highlights
Laparoscopic adjustable gastric banding (LAGB) includes the placement of a silicone ring around the stomach to create a small upper gastric pouch at the bottom of the esophagus
Weight loss after surgery was calculated using both total weight loss (%TWL), and excess weight loss (%EWL). %TWL was obtained applying the formula: × 100/initial weight. %EWL was calculated by dividing the number of kilograms lost by pre-operative excess body weight (EBW), assuming a healthy body mass index (BMI) at 25 kg/m2
The prevalence of comorbidities was 42.4% for type 2 diabetes mellitus (T2DM), 57.4% for hypertension, 28.7% for dyslipidemia, and 26.3% were diagnosed with obstructive sleep apnea (OSA)
Summary
Laparoscopic adjustable gastric banding (LAGB) includes the placement of a silicone ring around the stomach to create a small upper gastric pouch at the bottom of the esophagus. This procedure was introduced in the 1970s and remains safe, well tolerated, and efficacious with a relative low risk of serious complications. Laparoscopic adjustable gastric banding (LAGB) is one of the safest surgical procedures used for the treatment of obesity, and even though its popularity has been decreasing over time, it still remains an option for a certain group of patients, producing considerable weight loss and improvement in obesity-associated comorbidities
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