Evan Valle, MD, Minh B Luu, MD, Khristi M Autajay, RD, Louis F Fogg, PhD, Jonathan A Myers, MD. Rush University Medical Center
Background: Laparoscopic adjustable gastric banding (LAGB) is an effective and accepted procedure for weight loss. Long-term follow-up and band adjustments are crucial to achieve sustained weight loss but the optimal frequency is unknown. We compare the excess weight loss of two patient groups who are adjusted at different frequencies.
Methods: A total of 280 patients underwent LAGB over a 24 month period at two different surgical centers by a single surgeon. There were 156 patients from the academic center (AC) and 124 patients from the outpatient center (OC). We stratified the two cohorts into six-month subgroups according to length of follow-up. Statistical analysis of variance was performed using SPSS version 11.5.
Results: Patients from AC and OC were similar in age and preoperative BMI. Patient subgroup 0-6 months had 0.6 adjustments/month (adj/mo) and 18% EWL at AC compared to 0.7 adj/mo and 19% EWL at OC. Subgroup 6-12 months had 0.4 adj/mo and 27% EWL at AC compared to 0.5 adj/mo and 33% EWL at OC. Subgroup 12-18 months had 0.3 adj/mo and 25% EWL at AC compared to 0.5 adj/mo and 46% EWL at OC. Subgroup 18-24 months had 0.3 adj/mo and 31% EWL at AC compared to 0.3 adj/mo and 42% EWL at OC. Analysis of variance crossing six month groups with facility produced significant effects for groups (F=15.52, df=(4, 290), p<.001), center (F=14.28, df=(1,290), p<.001) and the center by group interaction (F=3.01, df=(4, 290), p<.02). It is clear from the pattern of means that there is a higher EWL percentage at the OC than at the AC.
Conclusion: Our data suggest that more frequent adjustments do result in increased EWL after LAGB, but an optimal frequency remains unknown. We believe that the difference noted between the two clinics stems from accessibility to band adjustments. Additional data points, such as EWL% at smaller monthly intervals and the point of diminishing results, should be investigated in future studies.
Program Number: P037