Abstract
BackgroundThe laparoscopic sleeve gastrectomy (LSG) is the most common bariatric procedure performed worldwide while the laparoscopic adjustable gastric banding (LAGB) has been almost abandoned. Aim of this study was to retrospectively assess 10-year outcomes of LSG through a matched comparison with LAGB.Materials and MethodsRetrospective search of prospectively maintained database of our university was carried out to find all patients that underwent LSG before December 2010. Each subject with LSG was matched one-to-one with a patient that had undergone LAGB in the same period with correspondent preoperative age, BMI, and sex.ResultsA total of 76 patients underwent LSG before 2010 and were all included in this study; a matched group of 76 out of 178 LAGB patients with 10-year follow-up was retrieved from our database. Comparison between the two groups showed better outcomes after LSG at 1 and 5 years but weight loss was comparable with the LAGB group at 10 years (%TWL 22.2 ± 13 vs 21.2 ± 16.1; p = 0.89). No significant difference was found in conversion/removal rate (15.8% vs 18.4%; p = 0.67).ConclusionLSG is an effective stand-alone bariatric procedure with better outcomes than LAGB in medium term, but results are comparable at 10 years. Subjects undergoing LSG should be informed that conversion to RYGB or OAGB may be necessary to achieve further weight loss or to treat reflux.Graphical abstract
Highlights
History of restrictive bariatric surgery goes back to the vertical banded gastroplasty (VBG) [1], which was described by Mason in 1982
A total of 152 (52 males/100 females) patients were included in this study; 76 patients underwent laparoscopic sleeve gastrectomy (LSG) before 2010 and were all included in this study; and a matched group of 76 out of 178 laparoscopic adjustable gastric banding (LAGB) patients with 10-year follow-up was retrieved from our database
VBG is not included in the guidelines of bariatric surgery while LSG is the most common intervention performed worldwide and LAGB has been almost abandoned
Summary
History of restrictive bariatric surgery goes back to the vertical banded gastroplasty (VBG) [1], which was described by Mason in 1982. This intervention was later modified by MacLean et al [2], who suggested to divide the gastric pouch from the remnant stomach. In the early 2000s, the laparoscopic adjustable gastric band (LAGB) replaced VBG as the most common restrictive procedure. Aim of this study was to retrospectively assess 10-year outcomes of LSG through a matched comparison with LAGB. Conclusion LSG is an effective stand-alone bariatric procedure with better outcomes than LAGB in medium term, but results are comparable at 10 years. Subjects undergoing LSG should be informed that conversion to RYGB or OAGB may be necessary to achieve further weight loss or to treat reflux
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