Vertical Banded Gastroplasty: Stable Trends in Weight Control at 10 or More Years

Whether long-term weight loss outcomes will succumb to adaptations in patients after gastric restrictive procedures has yet to be determined. The relationship, if any, of post-operative weight loss and maintenance to follow-up by support group and/or by surgeon, at least long-term, is uncertain. These questions have prompted review of my patients at 10-12 and at 5-10 years after vertical banded gastroplasty (VBG). Of the 118 patients (43 at 10-12 years), 65 were able to be contacted (55%). Successes were defined as patients who at the time of study interview, without operative revision, had lost at least 25% of their pre-operative excess weight. All known revisions (7) are reported as failures; only one of the seven was discovered in the study interviews. The mean body mass index of the entire study group (65) pre-operatively was 49.7, with 32% (21/65) super obese. Patient pre-operative profiles of successes and failures of both interval groups are remarkably similar. Successes were 65% in the >/= 10 year group and 68% in the 5-10 year group. Respectively, mean percent excess weight loss was 46% and 54%. Six (of seven) failures, and ten (of 13) successes, in the >/= 10 year group had 5.5 cm circumference outlets; all patients in the 5-10 year group were at 5.0 cm. Marked reduction in the follow-up pattern in the 5-10 year group failures was not significant but appears predictive. This experience suggests little deterioration in success rate, weight loss among successes, or revision requirement in VBG patients between 5 and > 10 years.