Application of laparoscopic adjustable gastric banding and a multi-disciplinary team approach in treatment of morbid obesity and its complications / 中国医学科学院学报

ABSTRACT

<p><b>OBJECTIVE</b>To assess the safety and feasibility of laparoscopic adjustable gastric banding (LAGB) and a multi-disciplinary team (MDT) approach in the treatment of morbid obesity and its complications.</p><p><b>METHODS</b>We retrospectively analyzed the clinical data of 16 patients who underwent LAGB and MDT approach in Peking Union Medical College Hospital from October 2009 to February 2011.</p><p><b>RESULTS</b>Of these 16 patients, 15 patients completed the 3 month follow up; their body weight and body mass index (BMI) decreased significantly after treatment (both P=0.000), with an percentage of excess weight loss (%EWL) of (25.7±7.4)%. Thirteen patients completed 6 month follow up; their body weight and BMI were significantly lower than the preoperative levels (both P=0.001), while there were no significant difference between the third and sixth month measurements (P=0.103 and P=0.053, respectively); %EWL of 6 months after operation was significantly higher than that of 3 months after operation [(37.0±14.7)% vs. (29.1±6.8)%,P=0.042]. Six patients completed 12 month follow up; their body weight and BMI decreased significantly at the first 3 months after operation (P=0.007 and P=0.005,respectively) and at the second 6 postoperative months (P=0.007 and P=0.013,respectively); the BMI of 6 months after operation was significantly lower than that of 3 months after operation (P=0.045), but there was no significant difference of body weight between the third and sixth month after operation (P=0.065); meanwhile, the %EWL increased significantly within the second 3 postoperative months from (29.6±6.8é% to(42.4±14.0é%(P=0.028), and also within the second 6 postoperative months (60.4±12.6é%(P=0.001). In 9 patients with pre-operative obstructive sleep apnea hypopnea syndrome, the symptom was remarkably resolved in all these 9 patients 3 months after the treatment. Of 16 patients with preoperative metabolic syndrome, the condition was obviously improved after treatment in 10 patients. Of 9 patients with hypertension preoperatively, the blood pressure returned to normal level after the withdrawal of antihypertensive agents in 7 patients; in addition, one patient had his dose decreased and one patient switched to a milder antihypertensive agent. Of 8 patients accompanied with type 2 diabetes, 7 had their antidiabetic drugs withdrawn after the blood sugar returned normal and one patient had his dose decreased.</p><p><b>CONCLUSION</b>LAGB combined with MDT approach is effective, safe, and feasible for treating morbid obesity and its complications.</p>