[Long-term results of vertical banded gastroplasty for morbid obesity]

Morbid obesity, defined by Body Mass Index (BMI) > 40 kg/m2, has an adverse effect on longevity due to a variety of illnesses. Among the numerous techniques proposed to control morbid obesity, Vertical Banded Gastroplasty (VBG) changes eating behavior. The aim of this study was to analyse the long term results of VBG.

Between October 1987 and July 1993, 62 patients, 7 men and 55 women, from 20 to 68 years old (Mean: 37.4 +/- 9 ans), underwent VBG for morbid obesity. Preoperative mean weight and BMI were 123 +/- 27 kg and 47.3 +/- 9.8 kg/m2 respectively. Associated diseases were diabetes mellitus (n = 31), hypertension (N = 29), hypercholesterolemia (N = 10), hypertriglyceridemia (N = 21) and joint diseases (N = 18).

VBG was performed with a 50 mm marlex mesh in 20 cases and with a 47 to 50 mm silastic ring in 42 cases. On patient died 3 years later from alcoholic liver cirrhosis and 4 were lost to follow-up. With a mean follow-up of 31 months, mean weight and BMI were 86 +/- 21 kg (p < 0.001) and 32.1 +/- 9.8 kg/m2 (p < 0.001) respectively. Removal of the ring was performed in 3 cases, 1 because of neurologic complications and 2 at the patient's request. Eight patients (13%) failed to achieve satisfactory weight loss. Diabetes mellitus and hypertension resolved in 19 cases, hypercholesterolemia resolved in 7 cases and hypertriglyceridemia resolved in 11.

VBG provides significant weight loss which reduces the frequency of medical disorders associated with obesity. This result was achieved in 87% of patients. The surgical procedure for morbid obesity must be decided conjointly with endocrinologist, psychiatrist and surgical staff for good long-term results.