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Is the Sleeve Gastrectomy Always a Better Procedure? Five-Year Results from a Retrospective Matched Case-Control Study

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Abstract

Introduction

Bariatric surgery is considered the most effective treatment for obesity. A recent worldwide survey demonstrated that Laparoscopic Sleeve Gastrectomy (LSG) is the most commonly performed bariatric procedure, while Laparoscopic Adjustable Gastric Banding (LAGB) has been almost abandoned.

Objectives

The aim of this retrospective study was to compare 5-year results of LSG and LAGB at our Institution.

Materials and Methods

Prospective maintained database of our Institution was reviewed to find all patients who had undergone LSG between January 2009 and December 2011. Inclusion criteria were BMI of 40–50 kg/m2 and age of 18–60 years old. Patients with Class I and II obesity, superobese subjects, and patients with previous history of bariatric surgery were excluded. Data on sex, age, pre-operative BMI, obesity-related diseases (diabetes, hypertension, dyslipidemia), and early and late complications were collected. Each subject who underwent LSG was matched one-to-one with a patient that had undergone LAGB. Outcomes were analyzed at 1, 3, and 5 years of follow-up.

Results

A total number of 122 patients were included in this study, 61 in each group. Better %EWL was observed in the LSG group at 1, 3, and 5 years. Both procedures induced improvements of obesity-related diseases without significant difference. In the LAGB group, ten patients underwent uneventful band removal. In the LSG group, two patients had serious postoperative complications.

Conclusion

LSG achieves better %EWL than LAGB within 5 years, but comorbidities improvement is not significantly different. Severity of complication is higher after LSG. LAGB is still a good option for selected patients.

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Authors and Affiliations

  1. Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Naples, Italy

    Antonio Vitiello, Luca Ferraro & Pietro Forestieri

  2. Department of Medicine, Surgery, and Dentistry, University of Salerno, Salerno, Italy

    Vincenzo Pilone

Authors
  1. Antonio Vitiello
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  2. Vincenzo Pilone
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  3. Luca Ferraro
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  4. Pietro Forestieri
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Correspondence to Antonio Vitiello.

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Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

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Vitiello, A., Pilone, V., Ferraro, L. et al. Is the Sleeve Gastrectomy Always a Better Procedure? Five-Year Results from a Retrospective Matched Case-Control Study. OBES SURG 28, 2333–2338 (2018). https://doi.org/10.1007/s11695-018-3161-8

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  • DOI: https://doi.org/10.1007/s11695-018-3161-8

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