Original articleComparative long-term mortality after laparoscopic adjustable gastric banding versus nonsurgical controls
Section snippets
Patients and procedures
The bariatric surgery cohort was extracted from 1015 morbidly obese patients consecutively treated with LAGB at the Centre for Medical and Surgical Therapy of Obesity, University of Padova, Italy, from January 1994 to December 2001. The clinical protocol used in our institution for the selection of obese patients for surgery has been previously described [9]. Patients were selected according to the inclusion criteria standardized by the National Institutes of Health [4]: only patients with a
Results
The baseline characteristics of the bariatric surgery and reference cohorts are reported in Table 1. Despite the matching procedure, the reference cohort had a mean age that was significantly older than that of the surgical cohort, with no differences in the obesity level. In the bariatric surgery cohort, the prevalence of type 2 diabetes at baseline was 25.1%, the prevalence of hypertension was 38.5%, and the prevalence of dyslipidemia was 25.9%. Sleep apnea was diagnosed in 39.7% of patients
Discussion
In this study, we analyzed the total mortality in a large series of morbidly obese patients treated with LAGB at a single tertiary Italian surgical center, and we compared the 5-year death rate after surgery with the total mortality of a comparable group of morbidly obese patients observed in tertiary Italian obesity care centers not using bariatric surgery. In our experience, LAGB was safe and effective [12], with a low rate of long-term complications and a weight loss that was lower than the
Conclusion
The results of our follow-up study have shown a clear reduction of total mortality in morbidly obese patients treated with LAGB compared with age-, gender-, and BMI-matched obese controls seeking treatment at medical centers. The level of evidence produced by our study was well below the level of evidence of a prospective randomized trial. However, our observations are in agreement with the results of epidemiologic studies investigating the relationship between intentional weight loss and total
Disclosures
A detailed list of potential conflicts of interest for all authors follows: Luca Busetto is a consultant for Medtronic, a speaker for Abbott Laboratories, and has received travel expenses from Sanofi-Aventis; Franco Favretti is a consultant for Medtronic; and Giuliano Enzi has received a research grant and travel expenses from Sanofi-Aventis.
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