Gastric Band after 15 Years: Migration Rates and Management.

IF 1.1 4区 医学 Q3 SURGERY
Niculae Iordache, Saleh Abujamra, Anamaria Nedelcu, Octav Ginghina, Razvan Andrei Stoica, Ramon Vilallonga, Marius Nedelcu
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Abstract

Background: Laparoscopic adjustable gastric banding (LAGB) was once a widely adopted bariatric procedure due to its reversibility and minimally invasive nature. However, concerns about long-term complications, particularly intragastric migration and slippage, have led to a decline in its use. Methods: We conducted a retrospective review of 411 patients who underwent LAGB between 2002 and 2010 at a tertiary care center. Data on demographics, complication rates, time to onset, and management strategies were analyzed. Follow-up data were available for 178 patients over a 15-year period. Results: Band migration was diagnosed in 33 patients (18.5%), with a median detection time of 74 months post-implantation. Most cases (54.5%) were diagnosed between 6 and 10 years postoperatively. Common clinical presentations included weight regain (45.4%) and port-site infection with fever (33.3%), while 21.2% were asymptomatic. Surgical removal was performed in all migration cases, with a laparoscopic approach successfully used in 84.8%. Conversion to open surgery was necessary in 2 patients, and primary laparotomy was used in 3 early cases. Band slippage occurred in 10.7% of patients, with 63.2% requiring surgical intervention. Postoperative complications were minimal and managed conservatively. Conclusions: Our findings confirm that LAGB is associated with a significant long-term risk of complications, particularly band migration, which may occur more than a decade postoperatively. Long-term follow-up is essential, and routine upper GI imaging should be considered in all patients with LAGB, especially in those presenting with port-site infections. These results highlight the importance of individualized management and long-term vigilance in patients undergoing LAGB.

15年后胃束带:迁移率和处理。
背景:腹腔镜下可调节胃束带(LAGB)因其可逆性和微创性而被广泛采用。然而,对长期并发症的担忧,特别是胃内迁移和滑脱,导致其使用减少。方法:我们对2002年至2010年间在三级保健中心接受LAGB治疗的411例患者进行了回顾性分析。统计数据、并发症发生率、发病时间和管理策略进行了分析。对178名患者进行了15年的随访。结果:33例(18.5%)患者被诊断出带移,中位发现时间为植入后74个月。大多数病例(54.5%)在术后6 - 10年被确诊。常见的临床表现包括体重回升(45.4%)和发热港部感染(33.3%),21.2%无症状。所有迁移病例均行手术切除,其中84.8%成功采用腹腔镜入路。2例患者转为开腹手术,3例早期患者行剖腹手术。10.7%的患者发生腱束滑脱,63.2%的患者需要手术干预。术后并发症极少,治疗保守。结论:我们的研究结果证实,LAGB与并发症的长期风险显著相关,尤其是术后10多年可能发生的腕带移位。长期随访是必要的,所有LAGB患者都应考虑常规的上消化道成像,特别是那些表现为端口感染的患者。这些结果强调了个体化管理和长期警惕的重要性,患者接受LAGB。
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来源期刊
CiteScore
2.90
自引率
0.00%
发文量
163
审稿时长
3 months
期刊介绍: Journal of Laparoendoscopic & Advanced Surgical Techniques (JLAST) is the leading international peer-reviewed journal for practicing surgeons who want to keep up with the latest thinking and advanced surgical technologies in laparoscopy, endoscopy, NOTES, and robotics. The Journal is ideally suited to surgeons who are early adopters of new technology and techniques. Recognizing that many new technologies and techniques have significant overlap with several surgical specialties, JLAST is the first journal to focus on these topics both in general and pediatric surgery, and includes other surgical subspecialties such as: urology, gynecologic surgery, thoracic surgery, and more.
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