Aim Retrospective multicenter analysis of the results of two different approaches for band positioning: perigastric and pars flaccida. Methods Data were collected from the database of the Italian Group for LapBand® (GILB). Patients operated from January 2001 to December 2004 were selected according to criteria of case-control studies to compare two different band positioning techniques: perigastric (PG group) and pars flaccida (PF group). Demographics, laparotomic conversion, postoperative complications, and weight loss parameters were considered. Dataare expressed as mean ± standard deviation. Results 2,549 patients underwent the LapBand System® procedure [age: 40 ± 11.7 years; sex: 2,130 female, 419 male; body mass index (BMI): 46.4 ± 6.9 kg/m2; excess weight (EW): 60.1 ± 23.6 kg; %EW: 90.1 ± 32.4]. During this period 1,343/2,549 (52.7%) were operated via the pars flaccida (PF group) and 1,206/2,549 (47.3%) via the perigastric approach (PG group). Demographics for both groups were similar. Thirty-day mortality was absent in both groups. Operative time was significantly longer in the PG group (80 ± 20 min versus 60 ± 40 min; p<0.05). Hospital stay was similar in the two groups (2 ± 2 days). Laparotomic conversion was significantly higher in the PG group (6 versus 2 patients; p<0.001). Overall postoperative complication rate was 172/2,549 (6.7%) and was linked to gastric pouch dilation/slippage (67/172), intragastric migration/erosion (17/172), and tube/port failure (88/172). Gastric pouch dilation and intragastric migration were significantly more frequent in the PG group: 47 versus 20 (p<0.001) and 12 versus 5 (p<0.001), respectively. Patients eligible for minimum 3-year follow-up were 1,118/1,206 (PG group) and 1,079/1,343 (PF group). Mean BMI was 33.8 ± 12.1 kg/m2 (PG group) and 32.4 ± 11.7 kg/m 2 (PF group) (p = ns), and mean percentage excess weight loss (%EWL) was 47.2 ± 25.4 and 48.9 ± 13.2 in PG and PF groups, respectively (p = ns). Conclusions Significant improvement in LapBand System ® results with regard to laparotomic conversion and postoperative complication rate, with similar weight loss results, was observed in the pars flaccida group. © Springer Science+Business Media, LLC 2010.
Laparoscopic adjustable gastric banding via pars flaccida versus perigastric positioning: Technique, complications, and results in 2,549 patients / N., Di Lorenzo; Francesco, Furbetta; Franco, Favretti; Giovanni, Segato; M., De Luca; Giancarlo, Micheletto; Marco, Zappa; P., De Meis; Ezio, Lattuada; Michele, Paganelli; Marcello, Lucchese; Basso, Nicola; Francesco D., Capizzi; L., Di Cosmo; Vincenzo, Mancuso; Simona, Civitelli; Angelo, Gardinazzi; Cristiano, Giardiello; Augusto, Veneziani; Marcello, Boni; Vincenzo, Borrelli; Angelo, Schettino; Pietro, Forestieri; Vincenzo, Pilone; Ida, Camperchioli; Michele, Lorenzo. - In: SURGICAL ENDOSCOPY. - ISSN 0930-2794. - 24:7(2010), pp. 1519-1523. [10.1007/s00464-009-0669-y]
Laparoscopic adjustable gastric banding via pars flaccida versus perigastric positioning: Technique, complications, and results in 2,549 patients
BASSO, Nicola;
2010
Abstract
Aim Retrospective multicenter analysis of the results of two different approaches for band positioning: perigastric and pars flaccida. Methods Data were collected from the database of the Italian Group for LapBand® (GILB). Patients operated from January 2001 to December 2004 were selected according to criteria of case-control studies to compare two different band positioning techniques: perigastric (PG group) and pars flaccida (PF group). Demographics, laparotomic conversion, postoperative complications, and weight loss parameters were considered. Dataare expressed as mean ± standard deviation. Results 2,549 patients underwent the LapBand System® procedure [age: 40 ± 11.7 years; sex: 2,130 female, 419 male; body mass index (BMI): 46.4 ± 6.9 kg/m2; excess weight (EW): 60.1 ± 23.6 kg; %EW: 90.1 ± 32.4]. During this period 1,343/2,549 (52.7%) were operated via the pars flaccida (PF group) and 1,206/2,549 (47.3%) via the perigastric approach (PG group). Demographics for both groups were similar. Thirty-day mortality was absent in both groups. Operative time was significantly longer in the PG group (80 ± 20 min versus 60 ± 40 min; p<0.05). Hospital stay was similar in the two groups (2 ± 2 days). Laparotomic conversion was significantly higher in the PG group (6 versus 2 patients; p<0.001). Overall postoperative complication rate was 172/2,549 (6.7%) and was linked to gastric pouch dilation/slippage (67/172), intragastric migration/erosion (17/172), and tube/port failure (88/172). Gastric pouch dilation and intragastric migration were significantly more frequent in the PG group: 47 versus 20 (p<0.001) and 12 versus 5 (p<0.001), respectively. Patients eligible for minimum 3-year follow-up were 1,118/1,206 (PG group) and 1,079/1,343 (PF group). Mean BMI was 33.8 ± 12.1 kg/m2 (PG group) and 32.4 ± 11.7 kg/m 2 (PF group) (p = ns), and mean percentage excess weight loss (%EWL) was 47.2 ± 25.4 and 48.9 ± 13.2 in PG and PF groups, respectively (p = ns). Conclusions Significant improvement in LapBand System ® results with regard to laparotomic conversion and postoperative complication rate, with similar weight loss results, was observed in the pars flaccida group. © Springer Science+Business Media, LLC 2010.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
