New U.s. Study Out

[Cocoabean 430]

Hello All,

I just found this study on Pub Med. It's the first long-term data I've seen on bands.

http://www.ncbi.nlm....pubmed/22219011

Long-term outcomes of laparoscopic adjustable gastric banding and laparoscopic Roux-en-Y gastric bypass in the United States.

Spivak H, Abdelmelek MF, Beltran OR, Ng AW, Kitahama S.

Source

HS Laparoscopy, Weight-Loss Surgery Program, Park Plaza Hospital, 1313 Hermann Drive, 1200 Binz Suite 930, Houston, TX, 77004, USA, hadarspivak@gmail.com.

Abstract

BACKGROUND:

Although laparoscopic adjustable gastric banding (LAGB) and laparoscopic Roux-en-Y gastric bypass (LRYGB) are the most common bariatric procedures performed in the past decade, little is known about their long-term (>5 years) outcomes.

METHODS:

A retrospective outcome study investigated 148 consecutive patients from a single practice who underwent LAGB from November 2000 to March 2002. The group was matched with 175 consecutive patients who underwent LRYGB from June 2000 to March 2005. Follow-up data for 5 years or longer was available for 127 LAGB patients (86%) and 105 LRYGB patients (60%).

RESULTS:

After an initial 4 years of progressive weight loss, body mass index (BMI) loss stabilized at 5-7 years at approximately 15 kg/m(2) for the LRYGB patients and at about 9 kg/m(2) for the LAGB patients with band in place (P < 0.01). At 7 years, the excess weight loss (EWL) was 58.6% for LRYGB and 46.3% for LAGB with band in place (P < 0.01). By 7 years, 19 LAGB patients (15%) had had their bands removed, bringing the failure rate forLAGB (including patients with less than 25% EWL) to 48.3% versus 10.7% for LRYGB (P < 0.01). By 10 years, 29 (22.8%) of the bands had been removed, bringing the total LAGBfailure rate to 51.1%. In 10 years, 67 LAGB (52.8%) and 43 LRYGB (41%) adverse events had occurred. However, over time, the LRYGB group experienced 9 (8.6%) serious, potentially life-threatening complications, whereas the LAGB group had none (P < 0.001). One procedure-related death occurred in the LRYGB group.

CONCLUSIONS:

Over the long term, LRYGB had an approximate reduction of 15 kg/m(2) BMI and 60% EWL, a significantly better outcome than LAGB patients experienced with band intact. The main issue with LAGB was its 50% failure rate in the long term, as defined by poor weight loss and percentage of band removal. Nevertheless, LAGB had a remarkably safe course, and it may therefore be considered for motivated and informed patients.

[horsegirl315 114]

Denise, you sure are doing a lot of research today!!! Keep it coming! LOVING IT! Had I seen these stats before and been UNINFORMED, I would be scared. However, I know that success can happen with the band, as evidenced by all the forum members I have seen here have incredible success. I'm not big on statistics anyway, because, you can never be sure how someone is going into surgery. They could be thinking they can continue their ways and the band will do all the work--but I know I am going to change.

[Cocoabean 430]

Hey Horsegirl! I am not big on stats, either. But it's good to know. If it happens to you, the odds are 100%. That's the way I look at it, anyway.

For me, I try to keep up with the ever changing world of medical information. Knowledge is power. I also see my surgeon once a year, and he checks me over and runs tests. My PCP checks my blood for the usual stuff plus Vitamin levels.

Do I worry about complications? Not really. Do I know they could happen, certainly. Signs and symptoms are in the back of head. If something happens to my band, I will deal with it then. My banded life has taught me to not be afraid of WLS. Bypass scared the bejeezus out of me. It still does to a degree. I didn't feel my health was "bad enough" to warrant it, although the qualifications for both surgeries are the same. My personal feeling was that one should need rapid weight loss to risk the malnutrition that can be caused by bypass. But if I lose my band, I'd certainly consider it now.

So far, I am extremely happy with my band...have I had "adverse events" as in the study? Probably, depending on what they were using as an adverse event. I have vomited. I've had diarrhea, Constipation. Were the last two cause by my band? I dunno. The first certainly was. But if I were part of a study, I'd have to list the last two and they'd go into the database.

Best wishes in your upcoming surgery!

[elcee 3,341]

It would be nice if they could write these reports in plain English so us average Joes can actually understand what they are talking about!

[horsegirl315 114]

Hey Horsegirl! I am not big on stats, either. But it's good to know. If it happens to you, the odds are 100%. That's the way I look at it, anyway.

For me, I try to keep up with the ever changing world of medical information. Knowledge is power. I also see my surgeon once a year, and he checks me over and runs tests. My PCP checks my blood for the usual stuff plus Vitamin levels.

Do I worry about complications? Not really. Do I know they could happen, certainly. Signs and symptoms are in the back of head. If something happens to my band, I will deal with it then. My banded life has taught me to not be afraid of WLS. Bypass scared the bejeezus out of me. It still does to a degree. I didn't feel my health was "bad enough" to warrant it, although the qualifications for both surgeries are the same. My personal feeling was that one should need rapid weight loss to risk the malnutrition that can be caused by bypass. But if I lose my band, I'd certainly consider it now.

So far, I am extremely happy with my band...have I had "adverse events" as in the study? Probably, depending on what they were using as an adverse event. I have vomited. I've had diarrhea, Constipation. Were the last two cause by my band? I dunno. The first certainly was. But if I were part of a study, I'd have to list the last two and they'd go into the database.

Best wishes in your upcoming surgery!

I agree....all we can do is inform ourselves, and pay attention to our bodies. Thanks, I'm so excited for my surgery!

[horsegirl315 114]

It would be nice if they could write these reports in plain English so us average Joes can actually understand what they are talking about!

The abbreviations had my head spinning!!

[Cocoabean 430]

I am not a statistics person...but if I interpreted it correctly...

15% had their bands removed by 7 years, by 10 years, 22.8%. At the same 7 year mark, excess weight loss for bandsters with bands in place is 46.3%, which is lower than RNY at 58.6% at 7 years.

They go on to say that including people who lose less than 25% of excess weight, the failure rate of banding is 51.1% over the long-term. They say that in 10 years bandsters have adverse events in 52.8% (none potentially life threatening), and 41% in RNY, with 8.6% being potentially life threatening and 1 death.

What isn't mentioned is what could be/would be considered an RNY failure. Which I realize maybe is not something that can be measured as for a band. Perhaps "failure" of RNY is included in the excess weight loss figure, as bypasses are seldom reversed and cannot be removed. So, I supposed failure would be lack of weight loss or weight gain.

So, why they would separate that out for bands and not bypass seems to skew the info to me...but it was not my study! :-)

[Lollicatt 36]

Another thing you have to consider with study like these, that they are usually, in some way biased. And it usually goes back to the funding of the study. Usually, the questions are formulated to favor one party, although its not obvious in the report. That could be why they specify the type of LB failure and not that of GB or VS. however, true medical studies are most likely valid, unless they are funded by a particular creator or manufacturer to promote a product. Im not saying that, this is, not a valid study, just something to consider. (I worked in a, marketing firm and have conducted and created all types of studies for multimillion $ companies)

Another thing to consider with studies and stats is that they have continued to improve the procedure, after care, support, etc in all WLS. i'm hoping that the next 10year study will prove, greater #s.

Just a thought :-)

[highland 168]

I think the key words in the stduy lie in the very last sentence; motivated and informed!

To me, this says it all about successful bandsters. It's the difference between success and failure.

[xavier 153]

Thanks, coco! I guess we are the motivated and informed patients! Great! I do think a lot of band failure comes from the doc's office not really knowing who has real addiction/depression/ psych issues and who just needs a little reigning in! The former group has the deck against them, I think. I am sure that's what the psych evals are for but I dont think you can really uncover all that in one office visit!

[Thomas Moore 0]

You know I did the same thing you did. Day in and day out all I did was prep for the surgery the side effects, I stressed myself out beyond words. The band in itself is an excellent tool for weightloss. But like everything else in life it is falable. When I say that you read a lot of horror stores about medical treatments every single day. In this case the lap band. Honestly I think a lot of it is the person, or operator error. You really have to change your brain befor you get the band. If you dont you will be absolutely miserable afterwords. Even today nine months post op I have to be super careful, I measure my food, I eat right. Like green foods, whole foods. Start cutting the crap out of your diet right now. Doing this is going to be very helpful in your sucess of surviving life post band. I get stuck pretty much every time I eat. I don't have a huge fill either. I have only had one fill in the whole time ive had it. Somethings I would reckomend for you which I still do today is juicing. juice fasting is a great way to prep your body for the surgery. You will get every thing that you need nutrition wise while adhering to the pre op diet. I do 1 and 2 week juice fasts to reset my bad every so often. Do the mental work now befor surgery because its going to make all the difference.

[Cocoabean 430]

Another thing you have to consider with study like these, that they are usually, in some way biased. And it usually goes back to the funding of the study. Usually, the questions are formulated to favor one party, although its not obvious in the report. That could be why they specify the type of LB failure and not that of GB or VS. however, true medical studies are most likely valid, unless they are funded by a particular creator or manufacturer to promote a product. Im not saying that, this is, not a valid study, just something to consider. (I worked in a, marketing firm and have conducted and created all types of studies for multimillion $ companies)

Another thing to consider with studies and stats is that they have continued to improve the procedure, after care, support, etc in all WLS. i'm hoping that the next 10year study will prove, greater #s.

Just a thought :-)

Great food for thought, thanks! Love your avitar, BTW!

I think the key words in the stduy lie in the very last sentence; motivated and informed!

To me, this says it all about successful bandsters. It's the difference between success and failure.

I agree. But you can also have people who do everything right and still lose their bands. Which sucks. But there are bypass patients who put their weight back on as well.

Thanks, coco! I guess we are the motivated and informed patients! Great! I do think a lot of band failure comes from the doc's office not really knowing who has real addiction/depression/ psych issues and who just needs a little reigning in! The former group has the deck against them, I think. I am sure that's what the psych evals are for but I dont think you can really uncover all that in one office visit!

I also think in the psych eval (if one is done) you have people who are highly motivated to say whatever is necessary to be approved for the surgery.

OTOH, you have someone needed coronary bypass surgery. The patient is sedentary and has a horrid diet. The surgeon performs the surgery, and tells the patient to eat right and exercise to improve their disease state. Sometimes they comply, sometimes they don't.

I do realize WLS is more complicated than this, because our goal is to lose weight in order to get healthier. I also realize that some people never experience restriction with their bands. I'd love to see a study on why that occurs.