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Laparoscopic Adjustable Silicon Gastric Banding versus Sleeve Gastrectomy
journal as an English language article. The study must have LASGB (83% women) and 40 (22-65) years for LSG (77%
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presented a universally accepted procedure in a specialized women). Nocca et al studied 163 patients (68% women) with
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laparoscopic institution with statistical case analysis and an average age of 41.57 years who underwent LSG. Turker
reported data on more than 40 patients. For weight or BMI data, et al studied LSG patients with a mean age of 42 ( 13-79) years
only data at least one year after surgery were considered. No and Weiner R et al studied 984 LASGB patients with a mean age
minimum follow-up for other outcomes was considered. For of 37.9 (18-65) years. 12,17 Other studies in the LASGB and LSG
quality-of-life outcomes, the study should have measured group had patients with similar age group. 18-22
quality of life before and after surgery. Data on comparative
studies where only included if values on LASGB and LSG were MEAN BODY MASS INDEX
clearly indicated and randomized. In cases of multiple reports The mean BMI in both study groups were similar. Himpens
from the same surgical center, double-counting of patients was worked on patients with a mean BMI of 37 (30-47) for LASGB
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avoided by including data and outcomes that were based on and 39 (30-53) for LSG (Not significant). Uglioni reported on
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the largest number of patients and still meeting the other 70 patients with a mean BMI of 46 (35-61) kg/m in SLG study
inclusion criteria. group in an attempt to find out the early and midterm results of
laparoscopic sleeve gastrectomy (LSG) as an isolated primary
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RESULTS and secondary operation after failed gastric banding. Similarly,
Nocca et al reported on LSG patients whose indications for this
A total of 703 articles where found. Twelve articles met the procedure in their study, were morbid obese [body mass index
inclusion criteria (Table 1). Five investigated LASGB. Six (BMI) > 40 kg/m ] or severe obese patients (BMI > 35 kg/m )
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investigated LSG. Only one prospective randomized study was with severe comorbidities (diabetes, sleep apnea, hypertension)
found comparing laparoscopic gastric banding and laparoscopic together with high-volume eating disorders and super-obese
sleeve gastrectomy. The total number of patients enrolled was patients (BMI > 50 kg/m ). Fuks et al reported on the data of
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4,519; the specific procedure totals were 3,714 for LASGB and 135 consecutive patients undergoing LSG between July 2004
805 for LSG. The age range of the population studied was and October 2007 prospectively. In this study, LSG was
13-79 years for LSG and 18-65 years for LASGB. The sex indicated only for weight reduction with a body mass index
distribution had a male : female ratio of 1:4 for LASGB and 1:3 (BMI) > 40 or > 35 kg/m associated with severe comorbidity. 23
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for LSG. Two of the reports are from the United States, two from Their aim was to evaluate the efficacy of LSG procedure on
Germany, three from France, one from Belgium, one from the weight loss, and short-term outcome. Preoperative mean body
UK, one from South Korea, one from Australia, and one from weight was 120.7 kg and mean body mass index (BMI) was 44.3
Switzerland. kg/m in the study of Zinzindohoue et al. 21
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PATIENT SELECTION OPERATIVE TIME, HOSPITAL STAY AND MORTALITY
In a prospective randomized study between laparoscopic gastric Only three of the 12 articles reported the details of the operative
banding and laparoscopic sleeve gastrectomy, Himpens et al time. Two of these were in the LSG and one in the LASGB
studied 80 patients with a mean age of 36 (20-61) years for group. Fuks et al reported a mean operating time of 103 minutes

Table 1: Results of articles studied
Study Date of surgery LASGB LSG No receiving Mean age Mean BMI
surgery
Weiner et al 20 1994-2002 Yes – 984 Not indicated 46.8 ± 7.2
Weiner et al 17 Not reported – Yes 120 Not indicated Not indicated
Nocca et al 19 2003-2006 – Yes 163 41.57 45.9
Tucker et al 12 2004-2007 – Yes 147 42 (13-79) 43.4
Himpens et al 18 Jan-Dec 2002 Yes Yes 80 LAGB 36 (20-61) 37 (30-47)
LSG 40 (22-65) 39 (30-53)
Fuks et al 23 July 2004-Oct 2007 – Yes 135 40 (18-65) 48.8 (37-72)
Chevallier et al 24 1996-2003 Yes – 1,000 40.4 (16.3-66.3) 44.3
Zinzindohoue et al 106 April 1997-June 2001 Yes – 500 40.4 44.3
Singhal et al 13 April 2003-June 2007 Yes – 1140 Not indicated 44.3 (35-88)
Sang Moon Han 26 Jan 2003- May 2004 – Yes 130 Not indicated Not indicated
Uglioni et al 22 May 2004-Oct 2007 – Yes 70 43 (21-65) 46 (35-61)
Dixon et al 25 Not indicated Yes – 50 Not indicated Not indicated

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