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 .
Vertical banded gastroplasty versus adjustable gastric banding: prospective long-term follow-up study.
BACKGROUND Vertical b and ed gastroplasty ( VBG ) has been in clinical use since 1979 and adjustable gastric b and ing ( AGB ) since 1985 . Because promising results were achieved with the adjustable gastric b and s available in the market , some surgeons came to the conclusion that VBG might be entirely ab and oned and replaced by the adjustable gastric b and . The aim of this study was to compare the long-term outcome of the 2 restrictive procedures . METHODS Within a 7-year period ( 1994 - 2001 ) , 1117 gastric restrictive procedures were performed in the course of a prospect i ve nonr and omized comparative trial . We report the outcomes of 563 VBG and 554 AGB procedures performed by 2 surgeons . The mean body mass index was 46.9 + /- 09.9 kg/m(2 ) for VBG and 46.7 + /- 07.8 kg/m(2 ) for AGB . Patient selection was performed by acceptance by 1 of the 2 surgeons . VBG was performed by laparotomy and AGB using laparoscopy . The Bariatric Analysis and Reporting Outcome System ( BAROS ) was used to evaluate the postoperative health status and quality of life . RESULTS The mean duration of follow-up was 92 months ( range 60 - 134 ) , with a minimum of 5 years . The overall follow-up rate was 92 % . In the short-term 3-year follow-up , no statistically significant difference was registered between AGB and VBG in terms of weight loss , reduction of co-morbidities , or improvement in quality of life . The 30-day mortality rate was .4 % ( 2 patients ) for VBG and .2 % ( 1 patient ) for AGB . The overall reintervention rate in the long term was 49.7 % for VBG and 8.6 % for AGB ( P < .0001 , odds ratio .0937 , 95 % confidence interval .065-.133 ) , the reoperation rate was 39.9 % for VBG and 7.5 % for AGB ( P < .0001 ) . The excess weight loss was significantly greater in the VBG group after 12 months ( 58 % for VBG versus 42 % for AGB , P < .05 ) . At long-term follow-up ( mean 92 months ) , no significant difference in weight loss was registered between the 2 study groups ( 59 % for VBG and 62 % for AGB , P = .923 ) . The BAROS score in the short term ( 3 years ) was good to excellent in 94 % and 90 % of the VBG and AGB groups , respectively . In the long-term follow-up period , the BAROS score was significantly in favor of the AGB group ( 83.9 % versus 57.8 % , P < .0001 , odds ratio 3.797 , 95 % confidence interval 2.072 - 7.125 ) . The overall resolution rate of co-morbidities was 80 % in both groups . CONCLUSION This long-term follow-up study shows that VBG and AGB are effective restrictive procedures to achieve weight loss , and loss of co-morbidities . A statistically significant lower re-intervention and re-operation rate and an improved health status and quality of life were registered for AGB
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 .