Weu Wang1, Cathy S J Fann2, Shwu-Huey Yang3, Hsin-Hung Chen4, Chih-Yen Chen5. 1. Division of Digestive Surgery, Department of Surgery, Taipei Medical University Hospital, Taipei, Taiwan; Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan. 2. Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan. 3. Department of Nutrition and Health Sciences, Taipei Medical University, Taipei, Taiwan. 4. Department of Nutrition and Health Sciences, Chang Jung Christian University, Tainan, Taiwan. 5. Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Bariatric and Metabolic Surgery Center, Taipei Veterans General Hospital, Taipei, Taiwan; Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan; Chinese Taipei Society for the Study of Obesity, Taipei, Taiwan. Electronic address: chency@vghtpe.gov.tw.
Abstract
OBJECTIVES: Obesity is a pandemic health problem. Bariatric surgery is the only efficient method for long-term effective weight loss in subjects with severe obesity. Laparoscopic adjustable gastric banding (LAGB) has been widely applied for weight loss. However, a novel technique called laparoscopic adjustable gastric banded plication (LAGBP) has been proposed as an alternative to LAGB. Surgeons generally consider LAGBP to have a relative advantage on weight loss than that derived from LAGB. This initial study applied various biostatistical models and considered a relative longer observation period to compare the effects of LAGB and LAGBP. METHODS: A total of 340 obese patients (290 who underwent LAGB and 50 who underwent LAGBP) with a body mass index of ≥35 kg/m2 and ages 20 to 55 y were recruited from the Division of General Surgery, Taipei Medical University Hospital in Taipei, Taiwan and observed for 24 to 36 mo postoperatively. RESULTS: Both surgical procedures resulted in significant weight loss, amelioration of poor glucose metabolism, and decreased serum triacylglycerol levels. However, the trend analysis showed no significant differences between the postoperative effects of LAGB and LAGBP (P for trend = 0.21 for body mass index reduction, 0.13 for total body fat percentage reduction, 0.25-0.29 for glucose metabolism amelioration, and 0.10-0.29 for blood pressure improvement). Improvements in serum total cholesterol and high-density lipoprotein cholesterol levels were observed after LAGB only and LAGBP only, respectively, at 24 mo postoperatively. The Framingham Coronary Heart Disease Risk score also showed significant decrease for patients who underwent LAGB and LAGBP. CONCLUSIONS: Both LAGB and LAGBP demonstrated comparable efficacy in reducing body weight and improving metabolic parameters in a 24 to 36 mo follow-up period. LABG showed the ability to reduce systolic blood pressure and LAGBP exhibited triacylglycerol-lowering effects. A longer observational period is needed in future studies.
OBJECTIVES:Obesity is a pandemic health problem. Bariatric surgery is the only efficient method for long-term effective weight loss in subjects with severe obesity. Laparoscopic adjustable gastric banding (LAGB) has been widely applied for weight loss. However, a novel technique called laparoscopic adjustable gastric banded plication (LAGBP) has been proposed as an alternative to LAGB. Surgeons generally consider LAGBP to have a relative advantage on weight loss than that derived from LAGB. This initial study applied various biostatistical models and considered a relative longer observation period to compare the effects of LAGB and LAGBP. METHODS: A total of 340 obesepatients (290 who underwent LAGB and 50 who underwent LAGBP) with a body mass index of ≥35 kg/m2 and ages 20 to 55 y were recruited from the Division of General Surgery, Taipei Medical University Hospital in Taipei, Taiwan and observed for 24 to 36 mo postoperatively. RESULTS: Both surgical procedures resulted in significant weight loss, amelioration of poor glucose metabolism, and decreased serum triacylglycerol levels. However, the trend analysis showed no significant differences between the postoperative effects of LAGB and LAGBP (P for trend = 0.21 for body mass index reduction, 0.13 for total body fat percentage reduction, 0.25-0.29 for glucose metabolism amelioration, and 0.10-0.29 for blood pressure improvement). Improvements in serum total cholesterol and high-density lipoprotein cholesterol levels were observed after LAGB only and LAGBP only, respectively, at 24 mo postoperatively. The Framingham Coronary Heart Disease Risk score also showed significant decrease for patients who underwent LAGB and LAGBP. CONCLUSIONS: Both LAGB and LAGBP demonstrated comparable efficacy in reducing body weight and improving metabolic parameters in a 24 to 36 mo follow-up period. LABG showed the ability to reduce systolic blood pressure and LAGBP exhibited triacylglycerol-lowering effects. A longer observational period is needed in future studies.
Authors: Bianca M Leca; Uzma Khan; Jenny Abraham; Louise Halder; Emma Shuttlewood; Neha Shah; Hugh L Ellis; Simon J B Aylwin; Thomas M Barber; Vinod Menon; Harpal S Randeva; Georgios K Dimitriadis Journal: Obes Surg Date: 2020-08 Impact factor: 4.129