M Pfister1, M P J Teuben1, H Teuber2, A Nocito3, P Probst1, M K Muller4. 1. Department of Surgery, Cantonal Hospital Thurgau, Pfaffenholzstrasse 4, CH-8501, Frauenfeld, Switzerland. 2. Department of Traumatology, University Hospital Zurich, Raemistrasse 100, CH-8091, Zurich, Switzerland. 3. Department of Surgery, Cantonal Hospital Baden, Im Ergel 1, CH-5404, Baden, Switzerland. 4. Department of Surgery, Cantonal Hospital Thurgau, Pfaffenholzstrasse 4, CH-8501, Frauenfeld, Switzerland. markus.k.mueller@stgag.ch.
Abstract
BACKGROUND: Revision surgeries in patients with failed gastric banding including band removal are increasingly necessary. However, long-term outcomes after band removal alone are unsatisfactory due to weight regain and limited improvement in quality of life. This study aimed to report mid-term quality of life outcomes after gastric band removal and single-stage conversion to Roux-en-Y gastric bypass. METHODS: Data of 108 patients who underwent conversion surgery from 2011 to 2017 were extracted from a prospective database and retrospectively analyzed. During follow-up visits, physical and laboratory data as well as quality of life questionnaires were obtained. RESULTS: Postoperative mean Moorehead score increased significantly after 1 year (1.62 ± 0.86, p < 0.001) and after 5 years (1.55 ± 0.84, p < 0.001) compared to baseline values (0.72 ± 1.1). The mean follow-up time was 53 months. Moorehead scores at 1, 2, and 5 years postoperative were available in 75% (n = 81), 71% (n = 77), and 42% (n = 45) of cases, respectively. Mixed ANOVA analysis showed a significantly superior increase in Moorehead score in males (p = 0.024). No other significant predictors were identified. Lasting BMI reduction (- 4.6 to 33.0 ± 6.7 kg/m2, p < 0.001) and weight loss (- 12.9% (- 13.6 kg), p < 0.001) 5 years after conversion surgery were seen. Postoperative complications occurred in 35% (n = 38) of patients with a re-operation rate of 30.5% (n = 33). CONCLUSION: The current study shows that band removal with single-stage gastric bypass in patients with failed gastric banding leads to a lasting improvement in quality of life and may be the rescue procedure of choice in this setting.
BACKGROUND: Revision surgeries in patients with failed gastric banding including band removal are increasingly necessary. However, long-term outcomes after band removal alone are unsatisfactory due to weight regain and limited improvement in quality of life. This study aimed to report mid-term quality of life outcomes after gastric band removal and single-stage conversion to Roux-en-Y gastric bypass. METHODS: Data of 108 patients who underwent conversion surgery from 2011 to 2017 were extracted from a prospective database and retrospectively analyzed. During follow-up visits, physical and laboratory data as well as quality of life questionnaires were obtained. RESULTS: Postoperative mean Moorehead score increased significantly after 1 year (1.62 ± 0.86, p < 0.001) and after 5 years (1.55 ± 0.84, p < 0.001) compared to baseline values (0.72 ± 1.1). The mean follow-up time was 53 months. Moorehead scores at 1, 2, and 5 years postoperative were available in 75% (n = 81), 71% (n = 77), and 42% (n = 45) of cases, respectively. Mixed ANOVA analysis showed a significantly superior increase in Moorehead score in males (p = 0.024). No other significant predictors were identified. Lasting BMI reduction (- 4.6 to 33.0 ± 6.7 kg/m2, p < 0.001) and weight loss (- 12.9% (- 13.6 kg), p < 0.001) 5 years after conversion surgery were seen. Postoperative complications occurred in 35% (n = 38) of patients with a re-operation rate of 30.5% (n = 33). CONCLUSION: The current study shows that band removal with single-stage gastric bypass in patients with failed gastric banding leads to a lasting improvement in quality of life and may be the rescue procedure of choice in this setting.
Authors: Felix Nickel; Lukas Schmidt; Thomas Bruckner; Adrian T Billeter; Hannes G Kenngott; Beat-Peter Müller-Stich; Lars Fischer Journal: Obes Surg Date: 2017-05 Impact factor: 4.129
Authors: Lars Sjöström; Kristina Narbro; C David Sjöström; Kristjan Karason; Bo Larsson; Hans Wedel; Ted Lystig; Marianne Sullivan; Claude Bouchard; Björn Carlsson; Calle Bengtsson; Sven Dahlgren; Anders Gummesson; Peter Jacobson; Jan Karlsson; Anna-Karin Lindroos; Hans Lönroth; Ingmar Näslund; Torsten Olbers; Kaj Stenlöf; Jarl Torgerson; Göran Agren; Lena M S Carlsson Journal: N Engl J Med Date: 2007-08-23 Impact factor: 91.245