Gastric bypass exceed the band in the long term: study

Gastric bypass exceed the band in the long term: study

NEW YORK (Reuters Health) – Among the surgical options for weight loss, gastric bypass produces more immediate complications that gastric band, but has fewer side effects and surgical repeats in the long term.

Moreover, in a study of more than 400 obese patients in Switzerland, those with gastric bypass lose weight faster and many did not regain weight.

“Ideally, these procedures would be slimming least amount of hassle in the long run, especially those requiring repeat surgery,” said study co-author Dr. Michel Suter, a surgeon at the Hospital of Chablais.

“The bypass has problems, adverse effects, and we have taken into account,” he said. But said: “If I had to choose a procedure, recommend the bypass.”

Still, a specialist outside the study explained that, when present, gastric bypass complications are more severe than those of the gastric band.

Suter’s team reviewed the medical records of 442 obese patients in their hospitals operated between 1998 and 2005.

For surgery, everyone should have a body mass index (BMI) of at least 40, or 35 if they had diseases associated with obesity. That’s a person of 1.70 meters, respectively, 112.5 or 98.5 kilograms.

Half had a gastric band that reduces the stomach size. The other half had undergone gastric bypass stomach bypass so that food does not travel a portion of the small intestine. Both groups had on average the same age and initial weight.

The doctors monitored at least twice a year for six years after surgery.

During the first month after surgery, complications (infections) were more common with bypass than with gastric banding. The 17 percent of bypass patients had a postoperative problem, compared with 5 percent of the group with gastric banding.

“The operation is slightly more complicated and risky,” said Suter.

But from that moment on, the bypass group lost weight faster, recover lost less weight and suffered fewer complications in the long term, including repeat surgery, participants with gastric banding.

Within six years, only 12 percent of bypass patients had a BMI above 35 (ie, morbid obesity), compared with one third of the group with the band.

And 13 percent required further surgery due to a complication of bypass, unlike 27 percent of patients treated with gastric banding.

The most common complications were gastric banding for band erosion and the need to extract, food intolerance or stretching of the esophagus, as detailed in the Archives of Surgery.

Gastric bypass, however, caused internal hernias, which are intestinal obstructions that may endanger life if not treated.

For the surgeon Christine Ren-Fielding, Faculty of Medicine, New York University, gastric bypass complications tend to be more severe than those of the band, but noted that the technique and surgeon experience are fundamental to the performance any surgery.

Weight loss surgery cost about $ 20,000. The band is cheaper than bypass surgery because it is simpler and shorter hospitalization, but Suter said the band adjustments over time can raise costs.

When it comes to choosing a procedure, Ren-Fielding said: “My philosophy is to help the patient achieve a result and optimize it, regardless of the surgery, because all bariatric operations have their benefits in the treatment of obesity.”

SOURCE: Archives of Surgery


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