Gender-specific Outcomes After Laparoscopic Adjustable Gastric Banding

Vadim Avulov, DO, David Brams, MD, FACS, Pamela J O’Brien, RN, MSN, NPC, Sara Tortorici, RN, MSN, NPC, Dmitry Nepomnayshy, MD, FACS. Lahey Clinic.

Introduction:
The objective of the study is to evaluate weather men loose more weight than women after a laparoscopic gastric banding procedure, as well as compare the rate of complications between the two genders.

Methods:
Analysis consisted of a single institution, retrospective cohort study of 553 patients who underwent laparoscopic adjustable gastric banding between 2006 and 2010. Follow-up beyond 2 years was available for 268 patients. Weight loss measure by the difference at the 2-3 year mark was compared against the initial consult weight. We defined successful weight loss at 2-3 year mark if a patient lost > 30% of their excess body weight.

Results:
Of the 268 patients, 211 (79%) were female and 57 (21%) male. The average initial weight at the time of presentation to the surgical weight loss center was 121 kg. At the 2-3 year mark, the average weight loss for males was 27.4 kg and for females 13.1 kg. Successful weight loss was accomplished in 61% of females and in 65% of males (p=0.602). During follow-up, there were a total of 9 band-related complications (3.4%), 7 in females (3.3%) and 2 in males (3.5%) (p=1.056). Table 1 compares the types of complications to the percent excess weight loss (%EWL) in each gender group.

Table 1

Gender	Band Complication	%ESL
M	Pain at port site	-3.43
M	Pain at port site	29.35
F	Band slippage	80.52
F	Band slippage	54.74
F	Esophageal food impaction	49.6
F	Dysphagia	44.3
F	Tubing disconnection	40.22
F	Port leakage	47.00
F	Port malfunction	83.97

Conclusions:
There is no statistically significant difference in the proportion of weight loss in males versus females after laparoscopic gastric band at 2-3 years. There was also no statistical variation in the rate of band-related complications in both genders. However, the complications in females were in the patients who were successful in loosing > 30% their excess weight, where the opposite held true for males.

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