Gastric Bypass with and Without Gastric Ring for the Treatment of Morbid Obesity: Results from Retrospective Analysis of a Prospective Database.

Abstract

Introduction: To assess the medium-term weight loss and maintenance of lean body mass (ideal weight/weight loss maintenance) following the Roux-en-Y gastric bypass (RYGB) surgical procedure with or without the use of a rigid gastric ring. Method: An observational cohort study with a retrospective approach was conducted to evaluate the effectiveness of RYGB with and without a band in patients with morbid obesity. The outcomes were assessed by analyzing data obtained from medical records, including pre- and postoperative data. Results: A total of 239 patients who underwent surgery between 2001 and 2018 were included, with 150 undergoing RYGB without a ring and 89 using a ring. The group subjected to the intervention with a rigid ring showed a significantly higher average body mass index loss than the ringless group (coefficient -2.45; 95% confidence interval [CI]: [-3.92 to -0.97], P < .001) at 1 year. After a follow-up period of 5 years, the use of a gastric ring was still associated with significant improvement in weight loss, even after multivariate adjustment (coefficient 6.62, 95% CI: [+ 4.30 ± 8.95], P < .001). Less than 5% of patients needed gastric band removal during the follow-up period. Conclusion: In this retrospective cohort of 239 patients, using a ring in RYGB was associated with a significant increase in weight loss and maintenance of lean body mass.