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Long-Term Matched Comparison of Adjustable Gastric Banding Versus Sleeve Gastrectomy: Weight Loss, Quality of Life, Hospital Resource Use and Patient-Reported Outcome Measures

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Abstract

Background

Comparisons of bariatric procedures across a range of outcomes are required to better inform selection of procedures and optimally allocate health care resources.

Aims

To determine differences in outcomes between laparoscopic adjustable gastric banding (LAGB) and laparoscopic sleeve gastrectomy (LSG) across nine outcome domains.

Methods

Matched primary LSG or LAGB across age, weight and surgery date were recruited. Data were collected from a prospective database and patient-completed questionnaires.

Results

Patients (n = 520) were well-matched (LAGB vs. LSG; age 41.8 ± 11.2 vs. 42.7 ± 11.7 years, p = 0.37; male 32.4% vs. 30.2%, p = 0.57; baseline weight 131.2 ± 30.5 vs. 131.0 ± 31.1 kg, p = 0.94). Follow-up rate was 95% at a mean of 4.8 years. LAGB attended more follow-up visits (21 vs. 13, p < 0.05). Mean total body weight loss was 27.7 ± 11.7% vs. 19.4 ± 11.1% (LSG vs. LAGB, p < 0.001). LAGB had more complications (23.8% vs. 10.8%, p < 0.001), re-operations (89 vs. 13, p < 0.001) and readmissions (87 vs. 32, p < 0.001). However, early post-operative complications were higher post-LSG (2.6 vs. 9.2%, p = 0.007). Length of stay (LOS) was higher post-LSG compared with LAGB (5.2 ± 10.9 vs. 1.5 ± 2.2 days, p < 0.001). LSG patients reported better quality of life (SF-36 physical component score 54.7 ± 7.9 vs. 47.7 ± 10.8, p = 0.002) and satisfaction (9.2 ± 1.9 vs. 8.4 ± 1.6, p = 0.001) and less frequent regurgitation (1.2 ± 1.2 vs. 0.7 ± − 1.1, p = 0.032) and dysphagia (2.0 ± 1.3 vs. 1.3 ± 1.6, p = 0.007).

Conclusion

This study showed high long-term follow-up rates in a large cohort of well-matched patients. Weight loss was greater with LSG. LAGB reported more re-operations and less satisfaction with the outcome. LOS was driven by patients with complications. This study has reinforced the need for comprehensive measurement of outcomes in bariatric surgery.

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Author notes

  1. Peter Nottle and Wendy Brown share senior authorship.

Authors and Affiliations

  1. Oesophago-Gastric and Bariatric Unit, Department of General Surgery, The Alfred Hospital, Commercial Rd, Prahran, 3004, Australia

    Yazmin Johari, Geraldine Ooi, Paul Burton, Cheryl Laurie, Richard Chen, Damien Loh, Peter Nottle & Wendy Brown

  2. Centre for Obesity Research and Education (CORE), Monash University, Level 6, The Alfred Centre, 99 Commercial Rd, Prahran, 3004, Australia

    Yazmin Johari, Geraldine Ooi, Paul Burton, Shourye Dwivedi, YunFei Qiu, Richard Chen & Wendy Brown

Authors
  1. Yazmin Johari
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  2. Geraldine Ooi
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Corresponding author

Correspondence to Yazmin Johari.

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Ethical Statement

Ethics approval was obtained from the Avenue Hospital Human Research Ethics Committee (project no. 213).

Consent Statement

All participants provided written informed consent.

Conflict of Interest

The product Formulite™ was donated by the manufacturer for the purpose of this study. Geraldine Ooi received a grant from the NHMRC, outside the submitted work. Wendy Brown received grants from Johnson and Johnson, grants from Medtronic, grants from GORE, personal fees from GORE, grants from Applied Medical, grants from Apollo Endosurgery, grants and personal fees from Novo Nordisc and personal fees from Merck Sharpe and Dohme, outside the submitted work. The rest of the authors declare that they have no conflict of interest.

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Johari, Y., Ooi, G., Burton, P. et al. Long-Term Matched Comparison of Adjustable Gastric Banding Versus Sleeve Gastrectomy: Weight Loss, Quality of Life, Hospital Resource Use and Patient-Reported Outcome Measures. OBES SURG 30, 214–223 (2020). https://doi.org/10.1007/s11695-019-04168-w

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  • DOI: https://doi.org/10.1007/s11695-019-04168-w

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