Reoperations were common in all groups .
Reoperation rate was initially high but reduced markedly with improved b and and surgical and aftercare techniques .
Conclusion All current procedures are associated with substantial and durable weight loss .
More long-term data are needed for one-anastomosis gastric bypass and sleeve gastrectomy  .
Reoperation is likely to remain common across all procedures
Introduction Durability is a key requirement for the broad acceptance of bariatric surgery .
Laparoscopic adjustable gastric banding versus Roux-en-Y gastric bypass: 10-year results of a prospective, randomized trial.
BACKGROUND There are few studies of long-term outcomes for either laparoscopic adjustable gastric b and ing ( LAGB ) or laparoscopic Roux-en-Y gastric bypass ( LRYGB ) . The objective of this study was to compare outcomes of patients r and omly assigned to undergo LAGB or LRYGB  at 10 years . METHODS LAGB , using the pars flaccida technique , and st and ard LRYGB were performed . From January 2000 to November 2000 , 51 patients ( mean age 34.0 ± 8.9 years ; range 20 - 49 ) were r and omly allocated to undergo either LAGB  ( n = 27 , 5 men and 22 women ; mean age 33.3 years ; mean weight 120 kg ; mean body mass index [ BMI ] 43.4 kg/m(2 ) ) or LRYGB ( n = 24 , 4 men and 20 women ; mean age 34.7 ; mean weight 120 kg ; mean BMI 43.8 kg/m(2 ) ) . Data on complications , reoperations , weight , BMI , percentage of excess weight loss , and co-morbidities were collected yearly . The data were analyzed using Student 's t test and Fisher 's exact test , with P<.05 considered significant . RESULTS Five patients in the LAGB group and 3 patients in the LRYGB group were lost to follow-up . No patient died . Conversion to laparotomy was performed in 1 ( 4.2 % ) of 24 LRYGB patients . Reoperations were required in 9 ( 40.9 % ) of 22 LAGB patients and in 6 ( 28.6 % ) of the 21 LRYGB patients . At 10-year follow-up , the LRYGB patients had a greater percentage of mean excess weight loss than did the LAGB patients ( 69±29 % versus 46±27 % ; P = .03 ) . CONCLUSION LRYGB was superior to LAGB in term of excess weight loss results ( 76.2 % versus 46.2 % ) at 10 years . However , LRYGB exposes patients to higher early complication rates than LAGB ( 8.3 % versus 0 % ) and potentially lethal long-term surgical complications ( internal hernia and bowel obstruction rate : 4.7 % )
Reoperations were common in all groups .
Reoperation rate was initially high but reduced markedly with improved b and and surgical and aftercare techniques .
Conclusion All current procedures are associated with substantial and durable weight loss .
More long-term data are needed for one-anastomosis gastric bypass and sleeve gastrectomy  .
Reoperation is likely to remain common across all procedures
Introduction Durability is a key requirement for the broad acceptance of bariatric surgery .