Banded Roux-en-Y gastric bypass for the treatment of morbid obesity.

Abstract

BACKGROUND:

Laparoscopic Roux-en-Y gastric bypass (LRYGB) is the most effective treatment for morbid obesity. The additional benefit of placing a nonadjustable band around the pouch remains to be determined. The objective of this study was to compare outcomes between banded and nonbanded LRYGB patients in a single bariatric center.

METHODS:

A matched cohort analysis was performed between patients who had undergone banded and nonbanded (standard) LRYGB. In the banded bypass cohort, an 8 F, 6.5 cm silastic ring was placed around the proximal gastric pouch. Both cohorts were matched for age, body mass index (BMI), and anastomotic technique. Endpoints included percentage excess weight loss (%EWL), postoperative morbidity, and band-related complications.

RESULTS:

Between January 2007 and July 2010, 134 banded LRYGB were performed (55% female, mean age 45 years). They were compared with a matched cohort of 134 concurrent nonbanded LRYGB patients (67% female, mean age 45.4 years). Mean preoperative BMI was 54.6 and 52.8 kg/m(2), respectively (P = .084). At 24 months postoperatively, the average %EWL was 58.6% in banded bypass patients and 51.4% in the nonbanded group (P = .015). The difference in EWL was more pronounced in super-obese patients than in those with BMI<50 (among super-obese, 57.5% versus 47.6%, P = .003; among those with BMI<50, 62.9% versus 57.9%, P = .406]. There was no difference in early (19.4% versus 19.4%) or late complications (10.4% versus 13.4%, P = .451) between banded and nonbanded LRYGB patients.

CONCLUSION:

Banding the pouch during LRYGB can be performed safely and may provide better weight loss, particularly in super-obese patients. Further prospective and long-term comparative studies of this technique are warranted.

• Authors: Helen M Heneghan, Shorat Annaberdyev, Shai Eldar, Tomasz Rogula, Stacy Brethauer, Philip Schauer
• Journal: Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery (Surg Obes Relat Dis) 2014 Mar-Apr Vol. 10 Issue 2 Pg. 210-6 ISSN: 1878-7533 [Electronic] United States
• PMID: 24462315 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2014 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

Topics

• Female
• Follow-Up Studies
• Gastric Bypass (methods)
• Gastroplasty (methods)
• Humans
• Laparoscopy (methods)
• Male
• Middle Aged
• Obesity, Morbid (surgery)
• Retrospective Studies
• Treatment Outcome