Minyoung Cho, MD, PhD1, Jung-Eun Kim, MD, PhD1, Bodri Son, MD, PhD1, Gyu-Hee Chae, MD, PhD1, Jae-Yong So, MD, PhD1, Sun-Ho Lee, MD, PhD2, Ha-Jin Kim, MD, PhD3, Kyungnam Eoh, MD1, Yun-Chan Park, MD4, Nam-Chul Kim, MD, PhD4. 1365mc Obesity Clinic LAMS Center, 2Global 365mc Hospital, 3Seoul 365mc Hospital, 4Busan 365mc Hospital
Background: Chronic illness including hypertension and diabetes means treatment is necessary throughout life. Obesity has declared a chronic disease. Many patients believe that the bariatric surgery is not a start to weight loss but a last resort. Patients tend to ignore the importance of visiting hospitals when they reach appropriate adjustment levels of the laparoscopic gastric banding (LAGB). This study evaluated what happens in that case.
Methods: The data were recorded by patients’ hospital visits who undertook the same day LAGB using LAP® APs for 8 years. The loss to follow-up (LTFU) is defined as the case where no visit has been made to a hospital for more than six months since LAGB.
Results: Only 497 out of 1,086 patients were followed up during the study (45.8%). Mean preoperative BMI was 35kg/m2 and age was 32 years-old. 90.9 % of the patients showed more than one LTFU (n=452, p<0.0001). The first LTFU started at 14.7 (0.2 – 52.8) months after LAGB. 78.7% of the LTFU patients occurred more than 1-year LTFU duration. %EBMIL at the first LTFU was 54.3% (-61.3 ~ +253). The gap time from the first LTFU to hospital revisit was 20.1 months (3 ~ 72.8). %EBMIL at the revisit was 50.1% (-381.9 ~ +306.3). 51% of the LTFU patients showed weight gain (+7.3kg) and the rest was lost (-8.8kg). 80.5% of the LTFU patients complained and developed adverse symptoms and signs such as solid food intolerance (40.3%), esophageal dilatation (16.2%), esophageal barium stasis (12.8%), liquid intolerance (5.1%), pouch dilatation (3.5%), slippage (2.4%), and erosion (0.2%) (p<0.0001). %EBMIL of the LTFU patients vs. Non-LTFU patients was 21.9% vs. 25.9%, 60.9% vs. 70.8, 59.3% vs. 76.5%, 60% vs. 95.6%, 49.6% vs. 88.3%, 45.6% vs. 106.3% at post-LAGB 1, 12, 24, 36, 48, and 60 months, respectively (p<0.05). Pseudoachalasia was more frequently developed in the LTFU (27.7% vs. 11.1%, p<0.05). Among the study participants, 39.2 percent (n=195) of the bands were removed and there was no difference between the two groups. Up to this series, the total explantation rate was 18%.
Conclusion: It is usually difficult to follow up regularly after bariatric surgery because patients mistake obesity as a treatment for weight loss through simple restrictive dietary control. To ensure a safe and good weight loss through the LAGB, proper diet and lifestyle changes must be made through regular hospital visits.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 93865
Program Number: P159
Presentation Session: Poster Session (Non CME)
Presentation Type: Poster