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 .
A 10-year Experience with Laparoscopic Gastric Banding for Morbid Obesity: High Long-Term Complication and Failure Rates
Background : Since its introduction about 10 years ago , and because of its encouraging early results regarding weight loss and morbidity ,  laparoscopic gastric b and ing ( LGB ) has been considered by many as the treatment of choice for morbid obesity . Few long-term studies have been published . We present our results after up to 8 years ( mean 74 months ) of follow-up . Methods : Prospect i ve data of patients who had LGB have been collected since 1995 , with exclusion of the first 30 patients ( learning curve ) . Major late complications are defined as those requiring b and removal ( major reoperation ) , with or without conversion to another procedure . Failure is defined as an excess weight loss ( EWL ) of < 25 % , or major reoperation . Results : Between June 1997 and June 2003 , LGB was performed in 317 patients , 43 men and 274 women . Mean age was 38 years ( 19 - 69 ) , mean weight was 119 kg ( 79 - 179 ) , and mean BMI was 43.5 kg/m2 ( 34 - 78 ) . 97.8 % of the patients were available for follow-up after 3 years , 88.2 % after 5 years , and 81.5 % after 7 years . Overall , 105 ( 33.1 % ) of the patients developed late complications , including b and erosion in 9.5 % , pouch dilatation/slippage in 6.3 % , and catheter- or port-related problems in 7.6 % . Major reoperation was required in 21.7 % of the patients . The mean EWL at 5 years was 58.5 % in patients with the b and still in place . The failure rate increased from 13.2 % after 18 months to 23.8 % at 3 , 31.5 % at 5 , and 36.9 % at 7 years . Conclusions : LGB appeared promising during the first few years after its introduction , but results worsen over time , despite improvements in the operative technique and material . Only about 60 % of the patients without major complication maintain an acceptable EWL in the long term . Each year adds 3 - 4 % to the major complication rate , which contributes to the total failure rate . With a nearly 40 % 5-year failure rate , and a 43 % 7-year success rate ( EWL > 50 % ) , LGB should no longer be considered as the procedure of choice for obesity . Until reliable selection criteria for patients at low risk for long-term complications are developed , other longer lasting procedures should be used
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 .