Stoma adjustable silicone gastric banding versus vertical banded gastroplasty for the treatment of morbid obesity

Abstract

Background: Among gastric restrictive operations, the procedure of choice is still controversial. The aim of this study is to compare the results of two different gastric restrictive procedures: vertical banded gastroplasty (VBG) and stoma adjustable silicone gastric banding (ASGB).

Methods: Between 1991 and 1996, 51 patients were treated surgically for morbid obesity: 27 underwent VBG and 24 underwent ASGB. Preoperative body weight (BW), body mass index (BMI) and percentage of ideal body weight (% IBW) were (mean+/-SD): 145.7+/-45.3 kg; 53.9+/-15.9 kg/m2; 249.1+/-73.5% respectively in the VBG group. Corresponding figures for the ASBG group were 132.5+/-22.7 kg; 46.9 7.8 kg/m2 and 207.2+/-35.0%.

Results: In the VBG group, the median follow-up period was 26 months (range: 7-47). Eighteen months after the operation BW, BMI, % IBW and percentage of excess weight loss (% EWL) were 85.5+/-26.8 kg, 31.9+/-9.8 kg/m2, 145.4+/-43.9% and 74+/-1% respectively. Complications included incisional hernia (n=1), and bowel obstruction (n=1). One patient died of acute myocardial infarction on the third postoperative day. In the ASGB group, median follow-up time was 19.7 months (range: 18-26). At 18 months postoperation BW, BMI, % IBW and % EWL values were 86.6+/-20.6 kg 30.6+/-6.6 kg/m2 140.6+/-29.3% and 64+/-1% respectively. Gastric wall erosion occurred in two patients and the bands had to be removed. These patients underwent VBG 6 months later. Complications encountered in this group were incisional hernia (n=1), outlet stenosis and reflux esophagitis (n=1), reservoir leakage (n=1) and gastrointestinal bleeding (n=1). Two patients died of pulmonary embolism and acute gastrointestinal bleeding.

Conclusions: Weight reduction was not statistically significant between the two groups. ASGB was easier to perform and less invasive than VBG.