Gastric bypass has better outcomes than gastric b and procedures for long-term weight loss , type 2 diabetes control and remission , hypertension , and hyperlipidemia .
Insufficient evidence exists regarding long-term outcomes for gastric sleeve resections
IMPORTANCE Bariatric surgery is an accepted treatment for obesity .
Despite extensive literature , few studies report long-term follow-up in cohorts with adequate retention rates .
OBJECTIVE To assess the quality of evidence and treatment effectiveness 2 years after bariatric procedures for weight loss , type 2 diabetes , hypertension , and hyperlipidemia in severely obese adults .
Safety and effectiveness of Realize adjustable gastric band: 3-year prospective study in the United States.
BACKGROUND The effectiveness and safety of bariatric surgery using laparoscopic adjustable gastric b and s have been demonstrated in numerous published studies . We present the results of the first U.S. multicenter trial of the Realize adjustable gastric b and , a laparoscopic adjustable gastric b and previously available only outside the United States as the Swedish adjustable gastric b and . METHODS A total of 405 morbidly obese patients were screened at 12 different centers from May to November 2003 to participate in a prospect i ve , single-arm study of the safety and effectiveness of the laparoscopically implanted Realize b and . Changes in excess body weight , the parameters of diabetes and dyslipidemia , and the incidence of complications were assessed at 3 years of follow-up . RESULTS Of the 405 patients , 276 ( 78.3 % women and 61.2 % white ) qualified for the study . The average age was 38.6 + or - 9.4 years ( range 18 - 61 ) , and the preoperative body mass index was 44.5 + or - 4.7 kg/m(2 ) . The mean hospital stay was 1.2 + or - 1.3 days . At 3 years , the average excess weight loss was 41.1 % + or - 25.1 % or a decrease in the body mass index of 8.2 kg/m(2 ) ( 18.6 % ) ( P < .001 ) . In diabetic patients with a baseline elevated hemoglobin A(1)c level , the level decreased by 1 % ( P < .001 ) . The total cholesterol , low-density lipoprotein cholesterol , and triglycerides decreased by 9 % , 16 % , and 50 % , respectively ( P < .001 ) , and the high-density lipoprotein cholesterol increased by 25 % ( P < .001 ) in patients with abnormal baseline values . One patient required conversion to an open surgical technique . No 30-day mortality occurred . The complication frequencies were generally low and included esophageal dysmotility in 0.4 % , late balloon failure in 0.4 % , b and erosion in 0.4 % , slippage in 3.3 % , esophageal dilation in 3.3 % , pouch dilation in 3.6 % , catheter kinking in 1.1 % , port displacement in 2.5 % , and port disconnection in 4.3 % . Reoperations were required in 15.2 % of the patients and involved 2 b and replacements , 9 b and revisions , 5 port replacements , 22 port revisions , and 4 explants . CONCLUSION The results of our study have shown that the Realize adjustable gastric b and is safe and effective in a diverse U.S. population of morbidly obese patients .  Significant weight loss was achieved throughout the 3 years of follow-up , with corresponding improvements in the indicators of diabetes and dyslipidemia
Gastric bypass has better outcomes than gastric b and procedures for long-term weight loss , type 2 diabetes control and remission , hypertension , and hyperlipidemia .
Insufficient evidence exists regarding long-term outcomes for gastric sleeve resections
IMPORTANCE Bariatric surgery is an accepted treatment for obesity .
Despite extensive literature , few studies report long-term follow-up in cohorts with adequate retention rates .
OBJECTIVE To assess the quality of evidence and treatment effectiveness 2 years after bariatric procedures for weight loss , type 2 diabetes , hypertension , and hyperlipidemia in severely obese adults .