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Ten-year Outcomes of a Prospective Randomized Trial of Laparoscopic Gastric Bypass Versus Laparoscopic Gastric Banding
Open accessAbstract
Objective: The primary endpoints of this study were long-term weight loss, morbidity, and changes in comorbidities and quality of life. Background: Bariatric surgery is an effective option for the treatment of severe obesity and its related comorbidities. However, few studies have reported on the long-term outcome (>5 yrs) of bariatric surgery. Methods: Between 2002 and 2007, 250 patients with a body mass index (BMI) of 35 to 60 kg/m 2 were randomly assigned to undergo laparoscopic gastric bypass or laparoscopic gastric banding. After exclusions, 111 patients underwent gastric bypass and 86 patients underwent gastric banding. Factors predictive of improved weight loss were analyzed using multiple logistic regressions. Results: At baseline, the mean age was 43 ± 10 years and the mean BMI was 46.5 ± 5.6 kg/m 2 . At 10-year follow-up, the mean total body weight loss for the entire cohort was −37.5 ± 19.4 kg, −42.4 ± 19.6 kg for gastric bypass versus −27.4 ± 14.5 kg for gastric banding. Late reoperation was significantly higher after gastric banding compared with the gastric bypass group (31.4% vs. 8.1%, respectively, P < 0.01). For the entire cohort, improvement or remission of diabetes occurred in 68%; 61% for hypertension; and 57% for dyslipidemia. The long-term mortality for the entire cohort was 1.0% at a mean follow-up of 9.5 ± 0.4 years. Factors predictive of improved weight loss included the type of operation (ie, gastric bypass), female sex, and the absence of diabetes at baseline. At long-term follow-up, quality of life continues to be improved from baseline for both the groups. Conclusions: Bariatric surgery is an effective treatment for severe obesity with durable 10-year weight loss and improvement in comorbidities and quality of life. Compared with gastric banding, gastric bypass was associated with better long-term weight loss, lower rate of late reoperation, and improved remission of comorbidities.
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“Four studies with a follow-up of at least 5 years were identified. Port-related and band-related complications were documented for 18%, 23%, 27% and 43% of patients [78, 80, 85, 89].”
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“Re-interventions for insufficient weight loss were reported by 3 studies at follow-up > 5 years, and documented for 6%, 12% and 18% of patients [78, 80, 85].”
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Cardiovascular effects of intensive lifestyle intervention in type 2 diabetes
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Long-term mortality after gastric bypass surgery
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Bariatric Surgery versus Intensive Medical Therapy for Diabetes — 3-Year Outcomes
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Health benefits of gastric bypass surgery after 6 years
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Long-term Outcomes of Bariatric Surgery
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Di Lorenzo, N., Antoniou, S. A., Batterham, R. L., Busetto, L., Godoroja, D., Iossa, A., Carrano, F. M., Agresta, F., Alarçon, I., Azran, C., et al. (2020) · Surgical Endoscopy · doi:10.1007/s00464-020-07555-y · Cited by 465
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Long-Term Weight Loss Strategies for Obesity
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Quality of Life after Bariatric Surgery—A Systematic Review
Sierżantowicz, R., Ładny, J. R., & Lewko, J. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19159078 · Cited by 109
Extensive weight loss reduces glycan age by altering IgG N-glycosylation
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Metadata
- Authors
- Nguyen, N. T., Kim, E., Vu, S., & Phelan, M.
- Affiliations
- University of California, Irvine Medical Center (US)
- University of California, Irvine (US)
- Corresponding author
- Nguyen, Ninh T.
- Kim, Eric
- Vu, Stephen
- Venue
- Annals of Surgery
- Published
- 2018-07
- Volume
- 268
- Issue
- 1
- Pages
- 106-113
- ISSN
- 0003-4932 (ISSN-L)
- 1528-1140
- PMC
- PMC5867269
- OpenAlex
- W2733709012
- Cited by
- 73
- References
- 12
- Citations by year
- 2026: 9 · 2025: 4 · 2024: 12 · 2023: 10 · 2022: 9 · 2021: 9 · 2020: 8 · 2019: 8 · 2018: 3
- FWCI
- 5.60
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Annals of Surgery (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- eScholarship (California Digital Library) (submittedVersion, cc-by)
- Funders
- National Institutes of Health (UL1TR001414)
- National Center for Advancing Translational Sciences
- 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 gastric bypass, laparoscopic adjustable gastric banding, bariatric surgery, morbid obesity, long-term weight loss, comorbidity remission, diabetes remission, hypertension, dyslipidemia, late reoperation, quality of life, predictors of weight loss
- MeSH terms
- Adolescent, Adult, Female, Follow-Up Studies, Humans, Male, Middle Aged, Obesity, Morbid, Laparoscopy, Postoperative Complications, Prospective Studies, Quality of Life, Gastric Bypass, Gastroplasty, Weight Loss, Logistic Models, Treatment Outcome, Young Adult
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- Nguyen, N. T., Kim, E., Vu, S., & Phelan, M. (2018). Ten-year Outcomes of a Prospective Randomized Trial of Laparoscopic Gastric Bypass Versus Laparoscopic Gastric Banding. Annals of Surgery. https://doi.org/10.1097/sla.0000000000002348
