Leca, Bianca M., Khan, Uzma, Abraham, Jenny, Halder, Louise, Shuttlewood, Emma, Shah, Neha, Ellis, Hugh L., Aylwin, Simon J. B. , Barber, T. M., Menon, Vinod, Randeva, Harpal S. and Dimitriadis, Georgios K. (2020) Laparoscopic adjustable gastric banding – should a second chance be given? Obesity Surgery, 30 . pp. 2913-2919. doi:10.1007/s11695-020-04613-1 ISSN 0960-8923.

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Abstract

Background:
Obesity is a chronic relapsing-remitting disease and a global pandemic, being associated with multiple comorbidities. Laparoscopic adjustable gastric banding (LAGB) is one of the safest surgical procedures used for the treatment of obesity, and even though its popularity has been decreasing over time, it still remains an option for a certain group of patients, producing considerable weight loss and improvement in obesity-associated comorbidities.

Methods:
The aim of this study was to evaluate the impact of weight loss following LAGB on obesity-associated comorbidities, and to identify factors that could predict better response to surgery, and patient sub-groups exhibiting greatest benefit. A total of 99 severely obese patients (81.2% women, mean age 44.19 ± 10.94 years, mean body mass index (BMI) 51.84 ± 8.77 kg/m2) underwent LAGB in a single institution. Results obtained 1, 2, and 5 years postoperatively were compared with the pre-operative values using SPPS software version 20.

Results:
A significant drop in BMI was recorded throughout the follow-up period, as well as in A1c and triglycerides, with greatest improvement seen 2 years after surgery (51.8 ± 8.7 kg/m2 vs 42.3 ± 9.2 kg/m2, p < 0.05, 55.5 ± 19.1 mmol/mol vs 45.8 ± 13.7 mmol/mol, p < 0.05, and 2.2 ± 1.7 mmol/l vs 1.5 ± 0.6 mmol/l). Better outcomes were seen in younger patients, with lower duration of diabetes before surgery, and lower pre-operative systolic blood pressure.

Conclusions:
Younger age, lower degree of obesity, and lower severity of comorbidities at the time of surgery can be important predictors of successful weight loss, making this group of patients the ideal candidates for LAGB.

Item Type:	Journal Article
Subjects:	R Medicine > RC Internal medicine R Medicine > RD Surgery R Medicine > RM Therapeutics. Pharmacology
Divisions:	Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Biomedical Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Biomedical Sciences > Translational & Experimental Medicine Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH):	Obesity -- Surgery -- Complications, Laparoscopic surgery, Gastric bypass , Hyperlipidemia , Hypertension , Weight loss
Journal or Publication Title:	Obesity Surgery
Publisher:	Springer
ISSN:	0960-8923
Official Date:	August 2020
Dates:	Date Event August 2020 Published 18 April 2020 Available 3 April 2020 Accepted
Volume:	30
Page Range:	pp. 2913-2919
DOI:	10.1007/s11695-020-04613-1
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Restricted or Subscription Access
Date of first compliant deposit:	17 April 2020
Date of first compliant Open Access:	20 April 2020

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