Bariatric surgery appears efficacious compared to st and ard care in reducing BMI .
Weight losses are greatest with diversionary procedures , intermediate with diversionary/restrictive procedures , and lowest with those that are purely restrictive .
Compared with Roux-en-Y gastric bypass , adjustable gastric b and ing has lower weight loss efficacy , but also leads to fewer serious adverse effects
Laparoscopic Adjustable Silicone Gastric Banding Versus Vertical Banded Gastroplasty in Morbidly Obese Patients: A Prospective Randomized Controlled Clinical Trial
Objective : To compare , in a prospect i ve , r and omized , single-institution trial laparoscopic adjustable silicone gastric b and ing ( LASGB ) with laparoscopic vertical b and ed gastroplasty ( LVBG ) in morbidly obese patients . Summary Background Data : LASGB is a simple and safe procedure , but some reports have suggested disappointing long-term results . Despite the recent widespread use of LASGB , there are no prospect i ve nor r and omized trials comparing LASGB with other laparoscopic procedures . Methods : A total of 100 morbidly obese patients , with body mass index ( BMI ) 40 to 50 kg/m2 , without compulsive eating , were r and omized to either LASGB ( n = 49 ) or LVBG ( n = 51 ) . Minimum follow-up was 2 years ( mean 33.1 months ) . Results : There were no deaths or conversions in either group . Mean operative time was 94.2 minutes in LVBGs and 65.4 in LASGBs ( P < 0.05 ) . Early morbidity rate was lower in LASGBs ( 6.1 % ) versus LVBGs ( 9.8 % ) ( P = 0.754 ) . Mean hospital stay was shorter in LASGBs versus LVBGs : 3.7 days versus 6.6 ( P < 0.05 ) . Late complications rate in LVBGs was 14 % ( 7 of 50 ) and in LASGBs 32.7 % ( 16 of 49 ) ( P < 0.05 ) . The most frequent complication was the slippage of the b and ( 18 % ) . Late reoperations rate in LVBGs was 0 % ( 0 of 50 ) versus 24.5 % ( 12 of 49 ) in LASGBs ( P < 0.001 ) . Excess weight loss in LVBGs was , at 2 years , 63.5 % and , at 3 years , 58.9 % ; in LASGBs , excess weight loss , respectively , was 41.4 % and 39 % . BMI in  LVBGs  was , at 2 years , 29.7 kg/m2 and , at 3 years , 30.7 kg/m2 ; in LASGBs , BMI was 34.8 kg/m2 at 2 years and 35.7 kg/m2 at 3 years . According to Reinhold 's classification , a residual excess weight < 50 % was achieved , at 2 years , in 74 % of LVBG and 35 % of LASGB ( P < 0.001 ) . Conclusions : This study demonstrates that , in patients with BMI 40 to 50 kg/m2 , LASGB requires shorter operative time and hospital stay but LVBG is more effective in terms of late complications , reoperations , and weight loss
Bariatric surgery appears efficacious compared to st and ard care in reducing BMI .
Weight losses are greatest with diversionary procedures , intermediate with diversionary/restrictive procedures , and lowest with those that are purely restrictive .
Compared with Roux-en-Y gastric bypass , adjustable gastric b and ing has lower weight loss efficacy , but also leads to fewer serious adverse effects