Banded Roux-en-Y gastric bypass for the treatment of morbid obesity |
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| Affiliation: | 1. Department of Surgery, Howard University College of Medicine, Towers Building, Suite 4100B, 2041 Georgia Avenue, NW, Washington, DC 20060, USA;2. Howard University College of Medicine, Washington, DC, USA;1. Section of Gastrointestinal Surgery, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden;2. Section of Vascular Surgery, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden;3. Department of Surgery, Örebro University, Örebro, Sweden;1. Department of Cardiovascular Surgery, Peter Munk Cardiac Centre, Toronto General Hospital, Toronto, Ontario, Canada;2. Department of Pathology, Peter Munk Cardiac Centre, Toronto General Hospital, Toronto, Ontario, Canada;3. Department of Cardiology, Heart Failure/Transplant, Peter Munk Cardiac Centre, Toronto General Hospital, Toronto, Ontario, Canada;4. Department of Interventional Cardiology, Peter Munk Cardiac Centre, Toronto General Hospital, Toronto, Ontario, Canada;1. Division of General Surgery, Department of Medico-Surgical Sciences and Biotechnology, “Sapienza” University of Rome, Latina, Italy;2. Division of General Surgery, Hospital of Villa d’Agri, Villa d’Agri Potenza, Italy;3. Division of General Surgery , Hospital Andosilla, Civita Castellana - Viterbo, Italy;1. Bicuspid Aortic Valve Program, Bluhm Cardiovascular Institute, Northwestern Memorial Hospital, Northwestern University, Chicago, Ill;2. Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Alberta, Canada;3. Division of Cardiac Surgery, Li Ka Shing Knowledge Institute of St Michael''s Hospital, Toronto, Ontario, Canada;4. Department of Surgery, University of Toronto, Ontario, Canada |
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| Abstract: | BackgroundLaparoscopic 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.MethodsA 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.ResultsBetween 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/m2, 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.ConclusionBanding 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. |
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| Keywords: | Bariatric surgery Roux-en-Y gastric bypass (RYGB) Banded gastric bypass Silicone ring Weight loss Morbid obesity |
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