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Weight Loss Results After Vertical Banded Gastroplasty Operation
Stomach Gastroplasty Not Preferred Surgical Operation to Treat Morbidly Obese Patients
Weight Loss After Vertical Banded Gastroplasty
Morbidly obese patients who undergo purely restrictive bariatric operations may fail to maintain satisfactory long-term results. In an attempt to achieve the best possible outcome after restrictive procedures, we have employed preoperative selection criteria and are following this selected patient group over time in order to evaluate long-term success.
From June 1994 through August 2000, 166 morbidly obese patients underwent various bariatric procedures at our institution. Of these patients, 35 underwent vertical banded gastroplasty based on selection criteria, including degree of obesity and dietary habits and eating behavior. All patients were seen at 1, 3, 6, 9, and 12 months postoperatively and yearly thereafter. Average follow-up time now is 4.1 years (29-75 mos.), and follow-up is 100%. A multivitamin and mineral supplement is administered to all patients for at least 6 months. Radiology examination is performed in all patients on the 4th postoperative day and at each yearly visit, in order to check for staple-line disruption and stomal stenosis.
Early postoperative morbidity was 5.7%. Late post-operative morbidity was 22.8%. A significant number of patients had some degree of stomal stenosis as shown by radiology examination, but to date there has been no need for surgical revision. There has been no early or late mortality. Weight loss results expressed as average percent excess weight loss (% EWL) were as follows: 61% (28-90) at 1 year, 61% (20-90) at 2 years, 57% (13-91) at 3 years, 56% (25-87) at 4 years and 37% (24-59) at 5 years following surgery. A significant number of patients with excellent weight loss had a high frequency of vomiting. Evaluation by BAROS showed that 25% of patients had an overall unsatisfactory outcome. Anemia and iron deficiency were found in 46% and 32% of vertical banded gastroplasty patients respectively. Recurrence of preexisting comorbidities was significant if lost weight was regained.
In spite of preoperative selection of patients for vertical banded gastroplasty, a significant percentage of patients had poor overall results in terms of weight loss, quality of life, and resolution of preexisting comorbidities. For these reasons and based on the long-term results published by others, vertical banded gastroplasty is no longer our preferred surgical option in morbidly obese patients.
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Laparoscopic or open bariatric surgery, such as gastric banding or bypass is not an easy solution to morbid obesity and weight loss. It is a serious surgical procedure, involving health risks. To produce lasting weight loss it requires a long-term patient commitment to eating a healthy diet and following a regular program of physical exercise. Life-long use of nutritional supplements may also be necessary. So, before deciding, discuss your options fully with your doctor. © 2003-2018 Bariatric-Surgery.Info - Terms - Contact - Information - Resources