The researchers followed 40 severely obese individuals who were considered high risk because of their body mass index (BMI), age and gender. Most were men over age 50 who also had diabetes or hypertension or both for two years.
The patients underwent one of two procedures to restrict the stomach size: sleeve gastrectomy or adjustable gastric banding. Regardless of the procedure, all surgeries were performed laparoscopically.
Two years after surgery, patients in both groups had lost substantial weight, but those who had had a sleeve gastrectomy shed, on average, 16 additional pounds.
The study is available online in the Journal of the Society of Laparoendosopic Surgeons.
“The gastric sleeve is an improvement in terms of total weight loss for these high-risk patients,” says study author Esteban Varela, MD, associate professor of surgery at Washington University School of Medicine in St. Louis and a bariatric surgeon at Barnes-Jewish Hospital. “There’s not a single type of obesity surgery that’s best for all patients. We think the gastric sleeve provides solid, safe results for these severely obese, high-risk patients.”
In a sleeve gastrectomy, a large part of the stomach is removed and the remaining is refashioned into a narrow tube to restrict food intake. Gastric banding involves placing an inflatable silicone ring around the upper stomach to limit food consumption.
Both procedures were safe and effective with no major complications. Patients in the sleeve gastrectomy group weighed an average 302 pounds before surgery and had a BMI of 45. These patients lost an average 65 pounds in the two years following surgery.
This compares with an average weight loss of 49 pounds for those in the gastric banding group. They began the study weighing an average 280 pounds and with a BMI of 43.
Varela conducted the study at the Dallas VA Medical Center before he joined the Washington University faculty.
Minor complications, while low in both groups, were slightly higher among patients who received the sleeve gastrectomy. They included nausea and vomiting and inflammation at the incision site. No patients in the study died, and none needed a second surgery because of complications.