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Cited by 287Bariatric Surgery and OutcomesMinimally Invasive Surgical TechniquesBody Contouring and Surgery

Laparoscopic adjustable gastric banding versus Roux-en-Y gastric bypass: 5-year results of a prospective randomized trial

Angrisani, Luigi, Lorenzo, Michele, Borrelli, Vincenzo·2007·Surgery for Obesity and Related Diseases
DOI 10.1016/j.soard.2006.12.005
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Abstract

Background To perform a prospective, randomized comparison of laparoscopic adjustable gastric banding (LAGB) and laparoscopic Roux-en-Y gastric bypass (LRYGB). Methods LAGB, using the pars flaccida technique, and standard LRYGB were performed. From January 2000 to November 2000, 51 patients (mean age 34.0 +/- 8.9 years, range 20-49) were randomly allocated to undergo either LAGB (n = 27, 5 men and 22 women, mean age 33.3 years, mean weight 120 kg, mean body mass index [BMI] 43.4 kg/m(2); percentage of excess weight loss 83.8%) or LRYGB (n = 24, 4 men and 20 women, mean age 34.7, mean weight 120 kg, mean BMI 43.8 kg/m(2), percentage of excess weight loss 83.3). Data on the operative time, complications, reoperations with hospital stay, weight, BMI, percentage of excess weight loss, and co-morbidities were collected yearly. Failure was considered a BMI of >35 at 5 years postoperatively. The data were analyzed using Student's t test and Fisher's exact test, with P <.05 considered significant. Results The mean operative time was 60 +/- 20 minutes for the LAGB group and 220 +/- 100 minutes for the LRYGB group (P <.001). One patient in the LAGB group was lost to follow-up. No patient died. Conversion to laparotomy was performed in 1 (4.2%) of 24 LRYGB patients because of a posterior leak of the gastrojejunal anastomosis. Reoperations were required in 4 (15.2%) of 26 LAGB patients, 2 because of gastric pouch dilation and 2 because of unsatisfactory weight loss. One of these patients required conversion to biliopancreatic diversion; the remaining 3 patients were on the waiting list for LRYGB. Reoperations were required in 3 (12.5%) of the 24 LRYGB patients, and each was because of a potentially lethal complication. No LAGB patient required reoperation because of an early complication. Of the 27 LAGB patients, 3 had hypertension and 1 had sleep apnea. Of the 24 LRYGB patients, 2 had hyperlipemia, 1 had hypertension, and 1 had type 2 diabetes. Five years after surgery, the diabetes, sleep apnea, and hyperlipemia had resolved. At the 5-year (range 60-66 months) follow-up visit, the LRYGB patients had significantly lower weight and BMI and a greater percentage of excess weight loss than did the LAGB patients. Weight loss failure (BMI >35 kg/m(2) at 5 yr) was observed in 9 (34.6%) of 26 LAGB patients and in 1 (4.2%) of 24 LRYGB patients (P <.001). Of the 26 patients in the LAGB group and 24 in the LRYGB group, 3 (11.5%) and 15 (62.5%) had a BMI of <30 kg/m(2), respectively (P <.001). Conclusion The results of our study have shown that LRYGB results in better weight loss and a reduced number of failures compared with LAGB, despite the significantly longer operative time and life-threatening complications.

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  • A total of 8 articles were used across more than 1 component.

    “A total of 8 articles were used across more than 1 component.141,142,144,148,156,159,168,169”

    From 2013 AHA/ACC/TOS Guideline for the Management of Overweight and Obesity in Adults (2014) · cites this paper as [141]

  • The complication evidence base included those studies from the efficacy and predictors searches that included complication data, as well as those studies that met the expanded search criteria.

    “The complication evidence base included those studies from the efficacy and predictors searches that included complication data,141,156 as well as those studies that met the expanded search criteria.139,143,145,146,152,153,160,170,171”

    From 2013 AHA/ACC/TOS Guideline for the Management of Overweight and Obesity in Adults (2014) · cites this paper as [141]

  • A total of 10 studies (12 articles) met the inclusion criteria, were rated as good or fair quality, and are included in the summary table.

    “A total of 10 studies (12 articles) met the inclusion criteria, were rated as good or fair quality, and are included in the summary table.141,142,144,148,151,155,156,159,161,168,169,172”

    From 2013 AHA/ACC/TOS Guideline for the Management of Overweight and Obesity in Adults (2014) · cites this paper as [141]

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Authors
Angrisani, L., Lorenzo, M., & Borrelli, V.
Corresponding author
Angrisani, Luigi
ORCID
Venue
Surgery for Obesity and Related Diseases
Publisher
Elsevier BV
Published
2007-03
Volume
3
Issue
2
Pages
127-132
ISSN
1550-7289 (ISSN-L)
DOI
10.1016/j.soard.2006.12.005
OpenAlex
W2163875017
Cited by
287
References
20
Citations by year
2025: 1 · 2024: 3 · 2023: 17 · 2022: 4 · 2021: 5 · 2020: 4 · 2019: 5 · 2018: 9 · 2017: 15 · 2016: 14 · 2015: 28 · 2014: 28 · 2013: 30 · 2012: 27
FWCI
26.96
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • Surgery for Obesity and Related Diseases (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
  • Health Sciences › Medicine › Surgery › Minimally Invasive Surgical Techniques
  • Health Sciences › Medicine › Surgery › Body Contouring and Surgery
Keywords
laparoscopic adjustable gastric banding, laparoscopic Roux-en-Y gastric bypass
MeSH terms
Adult, Female, Follow-Up Studies, Humans, Length of Stay, Male, Middle Aged, Obesity, Morbid, Laparoscopy, Postoperative Complications, Prospective Studies, Gastric Bypass, Gastroplasty, Weight Loss, Body Mass Index, Treatment Outcome

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