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2003, Number 4

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Cir Gen 2003; 25 (4)

Treatment of severe obesity with adjustable gastric band. Analysis of 445 patients

Álvarez CR, Aragón VE, Montoya RJ, Rocky VK, Toledo DA, Santa Rita SG, Sánchez RAL, Aquino AJ

Language: Spanish
References: 20
Page: 295-300
PDF size: 91.85 Kb.


ABSTRACT

Objective: To inform our experience in the use of the adjustable gastric band for severe obesity in 445 patients.
Design: Observational, retrospective, longitudinal study.
Setting: Third level health care hospital.
Measures: Central tendency measures and percentages.
Methods and material: We reviewed the clinical histories of 500 patients cared for from 1996 to 2002; all were studied according to the International Protocol of the Obesity Surgery Federation that includes: clinical history, biochemical profile, cardiovascular evaluation and pre-anesthetic assessment for surgical risk. An adjustable gastric band (Lapband) of 1 cm was placed at the esophageal gastric junction in all patients. We evaluated: weight, body mass index, percentage of body fat, records of biochemical profile, quality of life, co-morbidity, morbidity, and mortality.
Results: Fifty-five patients (11%) were lost during follow-up, leaving 445 patients for evaluation. From these, 363 (82%) were women and 82 (18%) were men; body weight ranged from 85 to 281 kg, the body mass index varied from 35.6 to 77.8, and body fat between 35 and 72%. Follow-up time was of 5 years. The mean weight loss was 36% during the first year, 59% during the second, 68% during the third, 69% during the fourth, and 65% during the fifth year. The three main co-morbidity’s were stress dyspnea, depression and/or anxiety, and joints pain. Seven (1.5%) early complications were encountered, 15 (3.3%) patients presented late complications; only four (0.9%) patients had to be converted to open surgery. No deaths occurred.
Conclusion: The adjustable gastric band placed through laparoscopy helps to loose weight, corrects co-morbidity’s, and has a low morbidity.


REFERENCES

  1. Obesity. Preventing and managing the global epidemic. Report of a World Health Organization Consultation on Obesity. Geneve, Switzerland, 2000.

  2. Health implications of obesity. National Institute of Health. Consensus Development Conference Statement. Ann Intern Med 1985; 103: 1073-7.

  3. Cowan GS Jr, Buffington CK. Significant changes in blood pressure, glucose, and lipids with gastric bypass surgery. World J Surg 1998; 22: 987-92.

  4. Alvarez CR, Panorama de la cirugía bariátrica en México. Cir Gen 1994; 16: 202-4.

  5. International Federation for the Surgery of Obesity. (IFSO). Statement on patient selection for bariatric surgery. Obes Surg 1997; 7: 41.

  6. Alvarez CR, Castillo GR, Ramírez WG. The Mexican technique for the laparoscopic placement of adjustable gastric band. (Abstract) Obes Surg 1999: 9: 138-9.

  7. Belachew M, Legrand M, Vincenti VV, Deffechereux T, Jourdan JL, Monami B, et al. Laparoscopic placement of adjustable silicone gastric band in the treatment of morbid obesity; how to do it. Obes Surg 1995; 5: 66-70.

  8. Alvarez CR. Atlas de cirugía de la obesidad. Editorial Paré. México, 1993; pp 48.

  9. Alvarez CR, García CA. Obesity surgery poly-parametric patient auto-evaluation. Obes Surg 1991; 1: 445-7.

  10. Oria HE. Reporting results in obesity surgery: Evaluation of a limited survey. Obes Surg 1996; 6: 361-8.

  11. Alvarez CR. Valoración integral del resultado de la cirugía en el paciente con obesidad severa. Cir Gen 1999; 21: 319-24.

  12. Alvarez CR, Aragón VE. Comparative analysis of three bariatric techniques with the B.A.R.O.S. system. (Abstract) Obes Surg 1999; 9: 131.

  13. Norma Oficial Mexicana para el Manejo Integral de la Obesidad. NOM.-174-SSA1-1998. Diario Oficial de la Federación, abril 12, 2000, pp 27-34.

  14. Alvarez CR. Estado actual de la cirugía para el tratamiento de la obesidad severa. Cir Gen 1999; 21: 257-8.

  15. Alvarez CR, Aragón VE, Post-operative complications in a series of gastric bypass patients. Obes Surg 1992; 2: 87-9.

  16. Cowan GS Jr. The Cancún IFSO. Statement on bariatric surgeon qualifications. Obes Surg 1998; 8: 86.

  17. Deitel M, Ternamian AM. Gynecologic-obstetric features of morbid obesity and the effect of weight loss. In: Update: Surgery for the Morbidly Obese Patient. FD Communications Inc. Toronto, Canadá, 2000, pp. 481-5.

  18. Van Gemert WG, Van Diele F, Soeters PB, Greve JWM. Quality of life before and after weight-reducing surgery and cost-effectiveness analysis. In: Update: Surgery for the Morbidly Obese Patient. FD-Communications Inc. Toronto, Canadá, 2000; pp 495-502.

  19. Weiss H, Nehoda H, Labeck B. Peer R, Aigner F. Gastroscopic band removal after intragastric migration of adjustable gastric band; a new minimal invasive technique. Obes Surg 2000; 10: 167-70.

  20. Alvarez CR. Obesidad y autoestima. McGraw-Hill Interamericana Ed., México, 1998.




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