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ISSN: 1895-4588
Videosurgery and Other Miniinvasive Techniques
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3/2014
vol. 9
 
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abstract:
Original paper

Comparison of percentage excess weight loss after laparoscopic sleeve gastrectomy and laparoscopic adjustable gastric banding

Andrzej Lehmann
,
Maciej Bobowicz
,
Paweł Lech
,
Michał Orłowski
,
Wiaczesław Siczewski
,
Maciej Pawlak
,
Dariusz Świetlik
,
Mieczysław Witzling
,
Michalik Maciej

Videosurgery Miniinv 2014; 9 (3): 351–356
DOI: https://doi.org/10.5114/wiitm.2014.44257
Online publish date: 2014/07/23
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Introduction: Laparoscopic sleeve gastrectomy (LSG) and laparoscopic adjustable gastric banding (LAGB) are acceptable options for primary bariatric procedures in patients with body mass index (BMI) 35–55 kg/m2.

Aim: The aim of this study is to compare the effects of these two bariatric procedures 6, 12 and 24 months after surgery.

Material and methods: Two hundred and two patients were included 72 LSG and 130 LAGB patients. The average age was 38.8 ±11.9 and 39.4 ±10.4 years in LSG and LAGB groups, with initial BMI of 44.1 kg/m2 and 45.2 kg/m2, p = NS.

Results: The mean percentage of excess weight loss (%EWL) at 6 months for LSG vs. LAGB was 36.3% vs. 30.1% (p = 0.01) and at 12 months was 43.8% vs. 34.6% (p = 0.005). The greatest difference in the mean %EWL at 12 months was observed in patients with initial BMI of 40–49.9 kg/m2 in favor of LSG (47.5% vs. 35.6%; p = 0.01). Two years after surgery there was no advantage of LSG and in the subgroup of patients with BMI 50–55 kg/m2 there was a trend in favor of LAGB (57.2% vs. 30%; p = 0.07). The multiple regression model of independent variables (age, gender, initial BMI and the presence of comorbidities) proved insignificant in prediction of the best outcome in means of %EWL for either operative modality. None of these factors in the logistic regression model could determine the type of surgery that should be used in particular patients.

Conclusions: During the first 2 years after surgery, the best results were obtained in women with lower BMI undergoing LSG surgery. The LSG provides greater %EWL after a shorter period of time though the difference decreases in time.
keywords:

obesity, laparoscopic sleeve gastrectomy, excess weight loss, comparison, laparoscopic adjustable gastric banding, treatment outcomes
  
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