Follow-up and Distance From Centre Are Important Determinants in Weight Loss Post Laparoscopic Adjustable Gastric Banding.

Introduction
In this study, we examine the importance of regular post-operative follow-up and the effect of geographical distance from the centre of follow-up on long term weight loss post laparoscopic adjustable gastric banding (LAGB).

Method
Over 11 years (1997- 2008), 140 patients underwent LAGB. Post-operatively patients were invited to attend a monthly nurse-led follow-up clinic, to assess weight loss and make necessary band adjustments. The demographic data, comorbidities, operation time, length of hospital stay and weight loss at each follow-up appointment were prospectively entered into a database for all patients using Microsoft EXCEL ©. %EWL was measured at each follow-up and records kept of the number of follow-ups per patient and the distance each patient had to travel to the surgical centre.

Results
128 females and 12 males, with a median age of 45 years (range 18-67), median start weight of 119 kg (range 88-220kg) and median BMI of 43.6 (range 35- 83) have had surgery to date. 78% of patients had at least one comorbidity associated with obesity. Median operative time was 35 minutes (range 22 – 90 minutes) and median length of hospital stay was 1 night (range 1-5 nights). Two patients did not attend follow-up post surgery.

Median % EWL at 1, 3, 6, 9, 12, 24 and 36 months post-operatively was 10%, 17%, 30%, 37%, 51%, 66% and 84% respectively. . Median %EWL at 12 months post LABG grouped by 0-3, 4-6, 7-9 and >10 follow-up attendances was 21 %, 44%, 52% and 56% respectively.

At a median of 22 months post-operatively, at the following distances from the centre of follow-up: 0-10, 10-20, 20-30 and >30 miles, median %EWL was 61%, 65%, 59% and 48% respectively and median number of follow-up attendances were 10, 10, 9 and 5 respectively.

Conclusion
With good local follow-up, weight loss from LABG can rival that achieved with more invasive procedures. Follow-up is the single most important determinant for weight loss after LABG. With increasing distance from the centre of follow-up, patients appear to attend fewer follow-up clinics, with consequently less weight loss.


Session: Podium Presentation

Program Number: S129

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