While this wasn't a randomized or blinded trial, the results were striking.
442 case-matched patients were followed for 6 post-operative years. Half received a gastric bypass, and half a gastric band.
While early minor complications were higher in the gastric bypass group (triple the rate seen in banding), major complications were similar. Aside from that, it's all bypass with the bypassed patients enjoying quicker losses, larger maximal losses and significantly better maintenance of losses.
How much better?
After 6 years, for every failed gastric bypass, there were 4 failed lap bands (with failure determined by BMI greater than 35 or reversal of the procedure). For every 1 long-term bypass complication there were 2 lap band complications, and for every 1 re-operation of a bypassed patient, there were 2 of lap banded ones.
Given how damning these results were, the journal invited noted band surgeon Jacques Himpens from Brussels to try to provide some balance in an after article commentary.
Dr. Himpens critiques?
- The study could have used surgeons known to be leading experts in banding and bypass.
- The mechanistic failing of banding to impact on weight related gut peptides might turn out to be an advantage in the very long term.
- The band is more readily reversible.
Seems like the decision of which surgery to have just became a great deal clearer for those who are considering one.
Romy, S., Donadini, A., Giusti, V., & Suter, M. (2012). Roux-en-Y Gastric Bypass vs Gastric Banding for Morbid Obesity: A Case-Matched Study of 442 Patients Archives of Surgery DOI: 10.1001/archsurg.2011.1708
Posts
Great post as always!
ReplyDeleteI must be abnormal with my results with the band. I love my band :) 115 lbs GONE for over a year now.
Hey Lap Band Gal,
DeleteGlad you're rocking your band. No doubt, many will, just it would seem, statistically fewer than those with RNYs.
Best,
Yoni
I'd just like to point out that there are other options when it comes to Weight Loss Surgery - and while I get the title of the post is because the study Dr Freedhoff is talking about only compared LapBand and Gastric Bypass, there are 2 other surgeries out there as well, one of which has arguably better statistics than even the Gastric Bypass (though I'm biased I'll admit, plus I haven't diligently read the research in a couple of years since I got surgery). The other 2 surgeries that people should research and consider are calles Vertical Sleeve Gastrectomy (VSG) and Duodenal Switch (DS).
ReplyDeleteConsider the difference between a 'bad outcome' with the various surgeries. A bad outcome for the lapband is , 'still obese' a bad outcome for gastric bypass/ RNY might be 'still obese AND permanently disabled'. The lapband is less effective , and always will be in such studies, because it requires greater commitment on the part of the patient. Basing the choice on this type of study , solely on the outcome of weight loss after a period of time, is dangerously flawed .
ReplyDeleteActuallly a bad outcome for lapband is not just less weight loss, the complication rate is what is being referred to in his article and there is quite a long list of potential (and some likely) complications that can be quite debilitating. Besides that I would argue that obesity in itself can be incredibly debiltating and create permanent disability.
DeleteBand bashing again. I know I'm 3 years out from banding, no longer obese and no complications so far. Even if I should have a complication, I'm very pleased with my results. RnY was not a consideration for me with my other health issues. Sleeve wasn't being done in my area at the time and DS is like RnY.. contraindicated for me. So, banding it was. And it's been a God-send.
ReplyDeleteLisa,
DeleteReporting peer reviewed study data isn't bashing.
I'm glad you're rocking your band.
The fact that you are though, doesn't mean that people who are considering banding shouldn't also be informed as to what the medical literature is saying about risks and benefits.
People read through their own lenses - and yours is a successful banding. You'll be happy then to hear, a band surgeon will be doing a guest post next week about this very study.
I can tell you I have had the band for just over two years. I lost 40 lbs that I do not contribute to the band. I worked very hard. The band had done nothing but make me physically ill every day. I started having complications in the last four months and gained all the weight back quickly. I am switching to gastric bypass in April. I have been miserable the entire time I have had the band and have ended up in the emergency room multiple times. I would never wish the hell of the band on anyone.
ReplyDelete