Abstract
Background
Patient-reported outcomes and perceptions are critical to the overall efficacy and acceptability of a surgical procedure. Outcomes, such as patient satisfaction and perceived success of the surgery and adverse symptoms, have not been described in detail following bariatric surgery. The associations and predictors of patient satisfaction have not been defined. This study aimed to examine long-term outcomes and perceptions after laparoscopic adjustable gastric banding (LAGB).
Methods
We conducted a prospective study of outcomes, satiety and adverse upper gastrointestinal symptoms, as well as quality of life and subjective patient satisfaction in LAGB patients. Data were collected at 3 years (T1) and 8 years post-operatively (T2).
Results
One-hundred and sixty patients completed follow-up at T1 and T2. The average age was 44.0 ± 11.2 years. At T2, the total body weight loss was 17.8 ± 11.9 %. Satisfaction decreased significantly between time points (8.6 ± 1.8 vs 7.2 ± 2.9, p < 0.01), and quality of life reduced slightly across all domains. Hunger scores remained low (3.8 ± 1.8 vs 3.9 ± 1.8, p = 0.61). The dysphagia score did not change significantly (p = 0.54). There was minimal change in frequency of regurgitation, although there was significant increase in patient assessment of how bothered they were by regurgitation. Multivariate analysis identified increased awareness of regurgitation as a principal driver of reduced satisfaction.
Conclusions
Weight loss, satiety and adverse symptoms demonstrated only slight changes between 3 and 8 years post-operatively. Despite this, overall satisfaction and perception of success of the procedure reduced markedly. This appeared mediated by reduced tolerance of adverse symptoms. These data inform follow-up practises aimed at optimizing outcomes.
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The Centre for Obesity Research and Education has received research support from Allergan and Apollo Endosurgery, Inc. and Apollo Endosurgery, the manufacturers of the LAP-BAND.
Wendy Brown declared that her research group (Centre for Obesity Research and Education) receives funding from the manufacturer of the LapBand™ (Allergan and Apollo Endosurgery) as well as from Applied Medical. She has received an honorarium from Merck Sharp and Dohme for lectures and Novo Nordisc for participation on a Scientific Advisory Panel. She has also received funding for a Bariatric Surgery Registry from the Commonwealth of Australia, Johnson and Johnson, Covidien/Medtronic, GORE, Applied Medical, Apollo Endosurgery and Allergan.
Paul Burton and Geraldine Ooi have received funding from the National Health and Medical Research Council (NHMRC) and the Royal Australasian College of Surgeons.
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The authors declare that they have no conflicts of interest.
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Burton, P.R., Ooi, G.J., Laurie, C. et al. Changes in Outcomes, Satiety and Adverse Upper Gastrointestinal Symptoms Following Laparoscopic Adjustable Gastric Banding. OBES SURG 27, 1240–1249 (2017). https://doi.org/10.1007/s11695-016-2434-3
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DOI: https://doi.org/10.1007/s11695-016-2434-3