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40% of Laparoscopic Gastric Banding Patients Have Complications
Tue - April 26, 2011 9:38 am  |  Article Hits:3118  |  A+ | a-
Since its introduction in 2001, the banding approach has become a popular option to Roux-en-Y gastric by-pass surgery, which involves the literal stapling of the stomach to be able to redirect food past part of the small intestine to instigate reduced food absorption in addition to a quicker sensation of satiety. But LAGB surgery originates under criticism in the past for involving a comparatively high risk for complications, including wound infection and injury to the spleen and esophagus, and a poor prognosis in terms of long-term standard of living. It is also been reported that LAGB patients will probably regain a lot of their dropped a few pounds years down the road. To explore satisfaction levels and also the long-term complication good reputation for gastric banding, in 2009 Himpens and the team examined a swimming pool of patients who had undergone the surgery between 1994 and 1997. The outcomes: 12 years or more later, more than 60 percent from the banding patients said they were satisfied with their experience. Normally, excess weight loss had been maintained at a level approaching nearly 43 percent, and excellence of life appeared to be equal to those of patients who had not undergone the surgery.

However, 39 percent of the patients had experienced serious complications, including abnormal pouch expansion, band erosion and band infection. Another 22 percent experienced relatively minor complications. Almost 50 percent needed the bands entirely removed, while 60 percent needed to undergo subsequent surgery. The procedure appears to result in relatively poor long-term outcomes, the researchers concluded. One in six of the patients ended up choosing to have a gastric bypass procedure, and all of these patients demonstrated good outcomes following their subsequent surgery. Himpens asserted patients should limit their expectations with respect to banding, noting that all weight-loss operations have a high failure rate. But he added that it is still defendable for surgeons to carry on carrying this out. The high failure rate of the band gastroplasty in the long run is not that much worse than other procedures, he noted therefore think patients will continue to inquire about the process. But he cautioned that patients undergoing band surgery must do so knowing that they need to commit themselves to rigorous long-term follow-up. Meanwhile, inside a critique published alongside Himpens work, Dr. Clifford W. Deveney, a professor of surgery in the department of surgery at Oregon Health and Science University in Portland, figured the present study does not shed a good light on the use of LAGB. The band includes a spotty history, Deveney said.

Some groups have excellent results, with 60 to 70 percent weight reduction. But other groups have either poor weight reduction or complications, or both. So I believe, he continued, that the patient should be made aware of these facts, and also that the weight loss is going to be less using the band compared to a gastric bypass. And that it'll take longer to offer the weight loss, since with gastric bypass most of the weight loss occurs within the newbie, while having a band it requires five to six years. It's also simpler to 'cheat' on the band, he added. You can eat round the band and render it ineffective if you are not disciplined in following a nutritious diet. With gastric bypass that isn't as much of a problem. But all of this is not to express which i think we shouldn't be doing bands. It's just not as good as bypass. Dr. Mitchell S. Roslin, chief of bariatric surgery at Northern Westchester Hospital in Mount Kisco, N.Y., said he wasn't surprised by the findings. I always tell my patients that bands are like going a diet having a seatbelt, he explained. And that there are bound to be a 5 percent extraction rate of these bands per year that they're in. Which actually involves about the same percent of band removals these researchers observed among their patients. I think the issue using the bands is merely that having a fixed obstruction underneath your esophagus is not a natural occurrence, Roslin noted. And also these bands make it more difficult to eat, but they don't make every patient less hungry. So there is a big variability in treatment effect. You will see patients who do great and patients who don't. Similar to a camel with two humps. So bands are simple to sell and incredibly heavily marketed, he added. But for many patients, you will find better options.
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