Department of Surgery, St. Claraspital, Basel, Switzerland.
Department of Surgery, St. Claraspital, Basel, Switzerland.
Surg Obes Relat Dis. 2017 Aug;13(8):1313-1319. doi: 10.1016/j.soard.2017.04.030. Epub 2017 Apr 29.
In the past, laparoscopic adjustable gastric banding (LAGB) seemed to be a promising bariatric procedure. However, many studies showed high rates of reoperation due to complications or insufficient weight loss. There is a lack of long-term studies with follow-up beyond 15 years.
To conduct long-term follow-up of patients after LAGB and analyze their weight loss as a primary endpoint.
Tertiary referral center for bariatric surgery, St. Claraspital, Switzerland.
A retrospective analysis of prospectively collected clinical data in a cohort of 405 patients having undergone LAGB was performed.
A total of 405 patients (age 41±10 years, body mass index [BMI] 44.3±6 kg/m) were treated with LAGB between 1996 and 2010. Mean follow-up was 13±3 years, with a follow-up rate of 85% (range 8-18 years), corresponding to 343 patients. One hundred patients exceeded 15-year follow-up. In 216 patients (63%), sleeve gastrectomy, gastric bypass, or biliopancreatic diversion with duodenal switch was performed as revisional surgery. Twenty-seven patients (8%) refused revisional surgery after band removal. Finally, 100 patients (29%) still have the band in place, with a mean BMI of 35±7 kg/m, corresponding to an excess BMI loss of 48±27%. Among these, the failure rate was 25%, according to the Bariatric Analysis and Reporting Outcome System (BAROS); 50% had a good to excellent outcome.
More than 10 years after LAGB, 71% of patients lost their bands and only 15% of the 343 followed patients with the band in place have a good to excellent result, according to BAROS.
过去，腹腔镜可调胃束带术（LAGB）似乎是一种有前途的减肥手术。然而，许多研究显示由于并发症或减重不足，需要进行高比例的再次手术。缺乏长期研究，随访时间超过 15 年。
对 LAGB 后的患者进行长期随访，并分析其减重作为主要终点。
瑞士圣克拉拉医院，三级转诊中心的减肥手术。
对 405 例行 LAGB 治疗的患者前瞻性收集的临床数据进行回顾性分析。
共有 405 名患者（年龄 41±10 岁，体重指数 [BMI] 44.3±6kg/m）于 1996 年至 2010 年接受 LAGB 治疗。平均随访时间为 13±3 年，随访率为 85%（范围为 8-18 年），对应 343 例患者。100 例患者随访时间超过 15 年。在 216 例（63%）患者中，行袖状胃切除术、胃旁路术或胆胰分流术加十二指肠转位术作为修正手术。27 例（8%）患者在去除束带后拒绝进行修正手术。最终，100 例（29%）患者仍保留束带，平均 BMI 为 35±7kg/m，对应的超重 BMI 减轻了 48±27%。在这些患者中，根据肥胖分析和报告结果系统（BAROS），失败率为 25%；50%的患者有良好到极好的结果。
在 LAGB 后 10 年以上，根据 BAROS，71%的患者失去了束带，仅有 15%的 343 例随访患者保留束带且结果良好到极好。
