• Surg Obes Relat Dis · Sep 2019

    Comparative Study

    Banded versus nonbanded laparoscopic sleeve gastrectomy: 5-year outcomes.

    • Mohit Bhandari, Winni Mathur, Susmit Kosta, Arun K Mishra, and David E Cummings.
    • Sri Aurobindo Institute of Medical Sciences, Mohak Hitech Specialty Hospital, Department of Bariatric Surgery, Indore, India.
    • Surg Obes Relat Dis. 2019 Sep 1; 15 (9): 1431-1438.

    Background/ObjectivesLaparoscopic sleeve gastrectomy (SG) is the most commonly performed bariatric/metabolic operation. However, inadequate long-term weight loss remains a problem in some cases, possibly from gastric-sleeve dilation. Adding a reinforcing ring around the proximal gastric sleeve has been proposed, but relevant data are scant. We performed the largest, longest-term study yet of banded SG (BSG) compared to nonbanded SG.SettingUniversity hospital.MethodsIn 2012, 68 patients at our institution underwent BSG, and 152 underwent SG. Data were prospectively collected into a standardized database from both cohorts during in-person visits at 0, .5, 1, 2, 3, 4, and 5 postoperative years, enabling this retrospective matched cohort study.ResultsThe groups were extremely well-matched at baseline for all relevant characteristics. Operative time was longer and blood loss greater with BSG, but these differences were clinically inconsequential. The only major perioperative complications were 1 hemorrhage in each group. Follow-up at 5 years was 81% for BSG and 67% for SG. Weight loss was equivalent between groups at 6 and 12 months. Thereafter, weight loss was substantially greater following BSG compared to SG at 2, 3, 4, and 5 years, with the magnitude of difference increasing at each successive year. At 5 years, total body mass index decrease was 33.0 ± 12.0% for BSG versus 21.7 ± 18.2% for SG (P = .0001). No major late complications occurred in either group. At 5 years, BSG patients reported minimal food intolerances, rare postprandial vomiting, and almost no heartburn.ConclusionsBSG is safe and produces substantially more weight loss than nonbanded SG at 2 through 5 postoperative years, with minimal side effects.Copyright © 2019 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

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