2005 Abstracts: Pattern of Weight Loss During the First 6 Months After Laparoscopic Adjustable Gastric Banding Predicts Success
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Pattern of Weight Loss During the First 6 Months After Laparoscopic Adjustable Gastric Banding Predicts Success
Sergey Lyass, Cedars-Sinai Medical Center, Los Angeles, CA; Scott. A. Cunneen, Cedars Sinai Medical Cenetr, Los Angeles, CA; Masanobu Hagiike, Monali Misra, Miguel Burch, Theodore M. Khalili, Gary Furman, Edward H. Phillips, Cedars Sinai Medical Center, Los Angeles, CA
Introduction. Laparoscopic adjustable gastric banding (LAGB) has gained a wide popularity outside the US and increasing popularity within the US due to the low morbidity and considerable weight loss. However, not all patients achieve adequate weight loss. Can early recognition of failure allow successful intervention?
Objective. To analyze the pattern of weight loss during the first 12 months after LAGB. Patients and Methods. Of the 255 patients who underwent LAGB from 1999 to 2004 in our institution 128 pts were followed for at least 12 months. Weight was obtained preoperatively and during each follow up visit. Multiple and logistic regressions were used for statistical analysis. Excess weight loss (EWL) below 30% was defined as a failure. Data is expressed as mean±SD or mean±SE*. Results. There were 32 males and 96 females with a mean age of 45±12 y. (19-70). Preoperative weight was 300±58 lbs, (199-487), with BMI of 48±7, (34-68). EWL was 30±11% (range 0-66) and 37±17% (range 0-102) at 6 and 12 months after operation respectively. 35% of pts did not achieve 30% EWL 12 months after LAGB. Weight loss was more substantial in the pts with lower preoperative BMI (b= (-) 0.89±0.23*, p=0.0002); and was not related to age, gender, co-morbidities and number of adjustments (multiple regression analysis). Logistic regression revealed that pts with excess BMI loss <18% at 3 months and < 30% at 6 months after operation had significant chance to loose less than 30% of EWL by the end of the year after operation (sensitivity and specificity of 75% and 53%; and 76% and 72% respectively). Conclusion: Weight loss after LAGB is closely related to preoperative weight. Weight loss pattern during the first 6 months after LAGB predicts the EWL at 12 months. This allows for early intervention, which may improve results.
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