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Laparoscopic Adjustable Gastric Banding (LAGB) Plus Anterior Fundoplication Versus LAGB Alone: A Prospective
Vincenzo Pilone1, Antonio Vitiello, Angela Monda
1*Department of Medicine and Surgery, University Hospital of Salerno, Salerno †Department of Endocrinology, Gastroenterology and Surgery, University Hospital of Naples "Federico II," Naples, Italy.
Background:
Laparoscopic adjustable gastric banding (LAGB) is a well-established and effective bariatric procedure, whose outcomes can be compromised by the slippage and the following removal of the band; the association between LAGB and gastric plication has recently been proved as a successful treatment for morbid obesity. The aim of this prospective randomized study was to compare weight loss and slippage rate between LAGB and LAGB plus anterior fundoplication.
Methods:
From January 2012 to May 2012, a total of 40 patients were allocated to undergo either LAGB (group A, n=20) or LAGB plus anterior fundoplication (group B, n=20). Data on the operative time, complications, hospital stay, total weight loss percentage (%TWL), percentage of excess weight loss (%EWL), and improvement of comorbidities were collected at 6, 12, and 36 months of follow-up.
Results:
All procedures were completed laparoscopically, and no significant difference of mean operative time was found between the 2 groups. The mean hospital stay was longer in group B than in group A (2.3±0.8 vs. 1.4±0.7 d, P<0.005). Greater weight loss was found in group B rather than in group A at 6, 12, and 36 months. Obesity related comorbidities improved in both groups. Number of band regulations and slippage rate were lower in group B.
Conclusions:
Our experience shows that 36 months after surgery LAGB plus anterior fundoplication increases weight loss and reduces the slippage rate.
