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    Gastric bypass causes greater weight loss than gastric banding; 27 lbs for women, 32 lbs for men


    Posted by .(JavaScript must be enabled to view this email address)
    Thursday, December 02, 2004 2:59 am Email this article
    Laparoscopic Roux-en-Y gastric bypass appears to be the therapy of choice [for morbid obesity]," concludes a new paper from Switzerland. Women lost approximately 92 lbs with gastric bypass vs 65 lbs with gastic banding

    Women who underwent Laparoscopic Roux-en-Y gastric bypass lost approximately 27 pounds more than those underwent laparoscopic gastric banding, a weight loss of approximately 92 pounds with gastric bypass compared to 65 pounds for laparoscopic gastric banding.

    Men lost approximately 110 lbs with gastric bypass vs 78 lbs with gastic banding

    Men who underwent gastric bypass lost approximately 32 pounds more with gastric bypass than with gastric banding, an average weight loss of approximately 110 pounds for gastric bypass compared to 78 pounds for gastric banding.

    (Note: Unfortunately the paper did not give the average weight loss for men and women. Therefore, I estimated the weight loss using the average starting and ending BMI given in the paper and an average height of 5-feet-4 for women, and 5-feet-10 for men.)

    BMI decreased from 48 to 32 with gastric bypass vs 48 to 37 with gastic banding

    In terms of body mass index (BMI), those who underwent gastric bypass decreased BMI from 47.8 to 31.9, whereas those who underwent gastric banding decreased their BMI from 48 to 36.8.

    Hospital Stay: 8 days for gastric bypass vs 3 days for gastric banding

    The average hospital stay for patients who underwent gastric bypass was 8.4 days compared to 3.3 days for gastric banding.

    Early complications: Reintervention for early complications 11 times more common with gastric bypass

    Reintervention for early complications was 11 times more common with gastric bypass.

    Reoperation was required in 7 patients who had gastric bypass for early complications compared to only 1 with gastric banding, and 4 with gastric bypass required other reintervention (endoscopic dilatation) compared to none in those who had gastric banding.

    Wound infection twice as common with gastric banding

    However, wound infection was twice as common with gastric banding, occurring in 16 patients, compared to 8 patients who had gastric bypass.

    Late complications 3 times more common with gastric banding

    Late complications, occurring more than one month after the operation, which included band slippage, were three time more common with gastric banding, occurring in 45 patients (44 percent) compared to 14 patients (13 percent) who had gastric bypass.

    Reintervention for late complications was required in 26 patients who had gastric banding compared to 9 who had gastric bypass.

    Advantages and disadvantages of both procedures

    “Both procedures are associated with advantages and disadvantages,” the authors of the paper note.

    “The laparoscopic gastric banding represents the least invasive bariatric procedure with the potential of full reversibility. However, increasing experience with laparoscopic gastric banding has shown a high incidence of long-term failures and complications.

    “For example, band erosion, band slippage, and esophageal dilatation occur between 15% and 58% of the cases.

    “In contrast, while more invasive and requiring extra surgical skills, the laparoscopic gastric bypass may offer better weight loss but might be associated with a higher incidence of surgical complications with a longer learning curve.”

    Subjects: 103 in each group, 82% women, 18% men, 20-62 years old

    The study involved 103 patients who underwent gastric bypass and 103 that underwent gastric banding.

    Eighty-four of the patients (82 percent) were female and 19 (18 percent) were male.

    Patients’ age ranged from 20- to 62-years-old, with the average age being 40.

    Medical problems prior to surgery

    Here are the percentages of medical problems before surgery.

    Hypertension disappeared in three-fourths of patients after surgery

    Hypertension was eliminated in 75 percent of patients who underwent gastric bypass, occurring in 52 percent of patients before surgery and only 13 percent after surgery.

    For those who had gastric banding, hypertension was eliminated in 70 percent of patients, occurring in 60 percent of patients before surgery and only 18 percent after surgery.

    Diabetes eliminated in 84% of patients with gastric bypass, 59% with gastric banding

    Diabetes disappeared in 84 percent of patients who had gastric bypass—38 before surgery and only 6 after surgery—and in 59 percent of patients who had gastric banding—45 before surgery compared to 18 after surgery.

    REFERENCE

    Weber M, Muller M, Bucher T, Wildi S, Dindo D, Horber F, Hauser R, Clavien P. Laparoscopic gastric bypass is superior to laparoscopic gastric banding for treatment of morbid obesity. Ann Surg. 2004 Dec, 240(6):975-83.

    AUTHOR’S CONTACT INFORMATION

    Markus Weber, MD
    Division of Visceral and Transplantation Surgery
    University Hospital Zurich
    Ra ?mistrasse 100
    8091 Zurich, Switzerland
    .(JavaScript must be enabled to view this email address)

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