Document Detail


Prospective randomized trial of banded versus nonbanded gastric bypass for the super obese: early results.
MedLine Citation:
PMID:  17544335     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Banded gastric bypass has been reported to result in superior weight loss compared with standard nonbanded gastric bypass. However, an adequate comparison of these procedures has not yet been reported. METHODS: A total of 90 patients were enrolled in this prospective randomized double-blind trial comparing banded and nonbanded open gastric bypass for the treatment of super obesity. The banding technique involved placement of a 1.5 x 5.5-cm polypropylene band around the proximal gastric pouch of a standard gastric bypass procedure using the technique of Capella. Chi-square testing and analysis of variance were performed to find any differences in patient characteristics (gender, age, and initial body mass index), percentage of excess weight lost at 6, 12, 24, and 36 months postoperatively, improvement or resolution of co-morbidities, and complications in the banded versus nonbanded gastric bypass groups. RESULTS: As expected, no differences were present in the patient characteristics or incidence of co-morbidities between the banded (n = 46) and nonbanded (n = 44) groups. The body mass index, percentage of women, and mean age was 59.5 and 56.5 kg/m2, 64% and 73.8% (P = .09), and 40.6 +/- 7.4 and 42.6 +/- 7.2 years for the banded and nonbanded groups, respectively; all differences were nonsignificant. No significant differences were found in the resolution of co-morbidities. No significant difference was present in the percentage of excess weight loss at 6, 12, and 24 months (43.1% versus 24.7%, 64.0% versus 57.4%, and 64.2% versus 57.2%, respectively) postoperatively; however, the banded patients had achieved a significantly greater percentage of excess weight loss at 36 months (73.4% versus 57.7%; P <.05). The incidence of intolerance to meat and bread was greater in the banded patients. The overall number of complications was 12 (26%) in the banded and 13 (29.5%) in the nonbanded group, a nonsignficant difference. No band erosions had occurred at the last follow-up visit, and no patients in either group died. CONCLUSION: These results suggest that although the initial weight loss was not significantly different between the 2 groups, the banded patients continued to lose weight for < or = 3 years. The polypropylene band appeared to be well tolerated. We plan longer follow-up to confirm the possibility of additional weight loss and the prevention of weight regain in the banded group, as well as to document any long-term band complications.
Authors:
Marc Bessler; Amna Daud; Teresa Kim; Mary DiGiorgi
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial     Date:  2007-06-04
Journal Detail:
Title:  Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery     Volume:  3     ISSN:  1550-7289     ISO Abbreviation:  -     Publication Date:    2007 Jul-Aug
Date Detail:
Created Date:  2007-07-30     Completed Date:  2007-10-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101233161     Medline TA:  Surg Obes Relat Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  480-4; discussion 484-5     Citation Subset:  IM    
Affiliation:
Center for Obesity Surgery, Columbia University, New York-Presbyterian Hospital, New York, New York 10032, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Analysis of Variance
Chi-Square Distribution
Comorbidity
Double-Blind Method
Female
Gastric Bypass / methods*
Humans
Male
Obesity, Morbid / surgery*
Postoperative Complications
Prospective Studies
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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