Department of General Surgery, University of Wuerzburg Hospital, Wuerzburg, Germany.
Obes Facts. 2009;2 Suppl 1(Suppl 1):27-30. doi: 10.1159/000198246. Epub 2009 Mar 18.
The success rate of laparoscopic adjustable gastric banding (LAGB) in the treatment of morbid obesity is very variable.A reasonable preoperative selection of eligible patients seems to be important for a successful outcome of LAGB. In the present study, criteria were investigated to predict the outcome of LAGB.
85 morbidly obese patients were operated with LAGB between 1999 and 2005. 71 of these patients were analysed according to several possible predictive parameters of success or failure of LAGB. Success was defined as excess body weight loss(EBWL) > 50% without band removal, failure was defined as EBWL < 20% and/or band removal. Median follow-up was 27 months (range 8-90 months).
After LAGB a median EBWL of 43% (-41 to 171.5%) was observed in all patients with a decrease in BMI of 8.0 kg/m2 (-9 to 35 kg/m2). The success rate after LAGB was 37%, the failure rate 19.7%. Female sex(p = 0.023), baseline weight (p = 0.024), and eating behaviour after LAGB (p = 0.008) were significant predictors of success following LAGB, whereas complications such as port dislocation and reoperation after LAGB did not have a significant impact on a successful course following LAGB. Significant predictors of failure were male sex (p = 0.038) and missing physical activity after LAGB (p = 0.045), whereas the eating behaviour did not have a significant effect concerning failure following LAGB. Baseline excess body weight (EBW) was identified as an independent predictor of failure in a multivariate analysis.
According to the results of this study, female patients with a lower EBW who improve their postoperative eating behaviour have the best chance of success following LAGB.
腹腔镜可调节胃束带术（LAGB）治疗病态肥胖的成功率差异很大。对合格患者进行合理的术前选择似乎对 LAGB 的成功结果很重要。在本研究中，研究了预测 LAGB 结果的标准。
1999 年至 2005 年间，对 85 例病态肥胖患者进行了 LAGB 手术。根据 LAGB 成功或失败的几个可能预测参数对其中 71 例患者进行了分析。成功定义为多余体重减轻（EBWL）> 50%且未移除束带，失败定义为 EBWL < 20%且/或移除束带。中位随访时间为 27 个月（8-90 个月）。
LAGB 后，所有患者的 EBWL 中位数为 43%（-41 至 171.5%），体重指数（BMI）下降 8.0 kg/m2（-9 至 35 kg/m2）。LAGB 后的成功率为 37%，失败率为 19.7%。女性（p = 0.023）、基线体重（p = 0.024）和 LAGB 后的饮食行为（p = 0.008）是 LAGB 后成功的显著预测因素，而 LAGB 后的并发症（如端口脱位和再次手术）对 LAGB 后的成功过程没有显著影响。男性（p = 0.038）和 LAGB 后缺乏体力活动（p = 0.045）是失败的显著预测因素，而饮食行为对 LAGB 后失败没有显著影响。基线多余体重（EBW）是多变量分析中失败的独立预测因素。
根据本研究结果，女性患者 EBW 较低且术后饮食行为改善者，LAGB 后成功的机会最大。
