Swedish Adjustable Gastric Band

An extreme measure but perhaps it is
safer than some other interventions for
the seriously obese.
And perhaps it would also help GERD.


1: Surg Obes Relat Dis. 2008 May-Jun;4(3 Suppl):S39-46.

Improvement in comorbid illness after placement of the
Swedish Adjustable Gastric Band.

Brancatisano A, Wahlroos S, Brancatisano R.

Institute of Weight Control, Sydney, Australia.
tony.brancatisano@iwcs.net.au

BACKGROUND:
Obesity and its related comorbid illnesses have become
a national health priority. We report comorbidity
and quality of life (QoL) data after
weight loss with gastric banding using
the Swedish Adjustable Gastric Band
(SAGB).

METHODS:
Data were collected prospectively for 838
consecutive morbidly obese patients who
underwent laparoscopic adjustable gastric
banding (LAGB) between January 2001 and
July 2007. Patients were followed-up by a
multidisciplinary team consisting of a
surgeon, physician, dietician, and
exercise consultant, all of whom were
involved in the evaluation of clinical
outcomes. Continuous data were reported
as mean +/- SD; categorical data were
reported as number and percentage.
Patients served as their own controls.

RESULTS:
Respective preoperative mean age, weight,
and body mass index (BMI) were
44 years (range 16-76), 122 kg (range 86-240),
and 44 kg/m2 (range 35-86), respectively.
SAGB implantation was accomplished by the
pars flaccida technique with no conversion
to an open procedure. Mature follow-up data
were available for 35% of patients at 24 months
and 21% at 36 months. In the total cohort of 838
patients, BMI (mean +/- SD) decreased to
32 +/- 5 kg/m2 and 32 +/- 7 kg/m2 at 24
months and 36 months, respectively.
Percentage excess weight loss (%EWL) (mean
+/- SD) was 32% +/- 14% (n = 506),
47% +/- 15% (n = 461), 52% +/- 16% (n = 291),
and 54% +/- 23% (n = 175) at 6, 12, 24,
and 36 months, respectively (P < .001).
There were 545 patients identified with
comorbid illness at >6-month follow-up.
After a median follow-up of 13 months
(range 6-36 months), resolution and/or
improvement of comorbidities was as follows:
type 2 diabetes mellitus, 79%;
metabolic syndrome, 78%;
hypertension, 67%;
dyslipidemia, 66%;
gastroesophageal reflux, 66%;
asthma, 57%;
arthritis/joint pain, 70%;
polycystic ovarian syndrome,48%; and
depression, 57%.
There was a significant improvement in QoL (as measured
by the Short Form-36 Health Survey [SF-36]),
bringing patients' QoL to a level
consistent with that of community norms
in all 8 domain scores. Of 342 patients
surveyed with the Beck Depression
Inventory (BDI-II), a statistically significant
improvement in depressive mood was also observed (P < .001).

CONCLUSION:
Weight loss achieved by use of the SAGB
provides a dramatic reduction in many serious
comorbid illnesses as well as improvement
in the psychosocial wellbeing of
morbidly obese patients.


PMID: 18501314 [PubMed - in process]

Related Links

An update on 73 US obese pediatric patients treated with
laparoscopic adjustable
gastric banding: comorbidity resolution and compliance data. [J
Pediatr Surg.
2008] PMID:18206472

Design and demography of the United States Swedish Adjustable
Gastric Band trial:
a 3-year prospective study. [Surg Obes Relat Dis. 2008] PMID:18501317

Weight loss and improvement of obesity-related illness following
laparoscopic
adjustable gastric banding procedure for morbidly obese patients in
Taiwan. [J
Formos Med Assoc. 2006] PMID:17098690

Weight loss and improvement of obesity-related illness in 500 U.S.
patients
following laparoscopic adjustable gastric banding procedure. [Am J
Surg. 2005]
PMID:15701486

A 6-year experience with the Swedish adjustable gastric band
Prospective
long-term audit of laparoscopic gastric banding. [Surg Endosc. 2005]
PMID:15549627
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