superobesity and lapbandclinicadrantoniosergio.pt › ... › 01 › superobesidade-e... ·...
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Superobesity and LapBand
8 Years Experience
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Superobesity
Index of Quetelet (Body Mass Index)
B.M.I. = Weight / Height2
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16,8 % of all patients with Lap Band
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MiddleMiddle Age Age ------------------------------ 38,8 38,8 YearsYears
minmin. . -------------------------------------------- 18 18 yearsyears
maxmax. . ------------------------------------------ 66 66 yearsyears
Female – 78,8%
Male -21,2%
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Middle Weight 153,4 Kg
minimal 116 Kg
maximum 263 Kg
Median Body Mass Index (BMI)
56,7 Kg/m2
minimal 50,1 Kg/m2
maximum 77,3 Kg/m2
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COMORBIDITIESCOMORBIDITIES
160 PATIENTS 160 PATIENTS –– (80%)(80%)
••OSTEOARTROPHATY(jointOSTEOARTROPHATY(joint painpain) ) ------------------ 57%57%
••Arterial Arterial HypertensionHypertension ------------------------------------------ 32%32%
••Diabetes Diabetes mellitusmellitus typetype 2 2 -------------------------------- 43,7%43,7%
••RoncophatyRoncophaty ---------------------------------------------------------------- 32%32%
••SleepSleep ApneaApnea SyndromeSyndrome ------------------------------------ 16%16%
••HypotirodismHypotirodism -------------------------------------------------------- 0,8%0,8%
••HiatalHiatal HerniaHernia ---------------------------------------------------------- 6%6%
••GRD + GRD + HiatalHiatal HerniaHernia ------------------------------------------ 2%2%
••CholelitiaseCholelitiase ____------------------------------------------------------ 10%10%
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Middle time of surgery --- 65 mns
min. 40 mns – max. 190 mns
Median time of Hospital Stay2 days
min. 1 day --- max. 16 days
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PostPost operativeoperative MorbidityMorbidity
��2 2 portport infectionsinfections ------------ replacementreplacement
��1 1 bandband infectioninfection ---------------------- removalremoval
��PneumonyaPneumonya ------------------------ 2 2 patientspatients
��DisphagiaDisphagia -------------------------------- 3 3 patientspatients
��T E P T E P ------------------------------------------ 1 1 patientpatient
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Complications with LapBand
5.0%5.1%10.121TOTAL
1.5%1.53Port infection
3.6%3.67Break/desc port-tube
1.5%1.53Band rupture
0.5%0.51Band infection
1.5%1.53Slippage
1.5%1.53Pouch dilatation
Maj. SurMin.Sur%Nº pat.
Kind
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REINTERVENTIONSREINTERVENTIONS
� 11 major- 5,55%
3 - replacements
6 – band reposition
1 – Conversion to Scopinaro
1 – Conversion to sleeve gastrectomy
� 10 minor – 5%
Replacement of port ----------- 4
reconnection tub / port -------- 6
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Follow-up
� 3 months-- 196/198
� 6 months-- 196/198
� 9 months-- 174/178
� 12 months- 156/160
� 18 months- 131/137
� 24 months- 112/119
� 36 months---- 82/88
� 48 months---- 47/52
� 60 months---- 26/29
� 72 months---- 20/20
� 84 months---- 20/20
� 96 months ---- 4/4
96,4%
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Evolution of Weight, BMI and % EWL on superobese patients
0
20
40
60
80
100
120
140
160
0 3 6 9 12 18 24 36 48 60 72 84 96
Weight
BMI
%EWL
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Evolution of Comorbidities
Comorbidities Nºpatients
Withoutdisease
Improved Unchanged
Osteoartrophaty 91 45 39
Roncophaty 51 32 18
Arterial Hypertension 51 28 15 8
Sleep Apnea Sind. 26 13 10
Type 2 Diabetes 70 48 16 6
3
1
7
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CONCLUSION
� Our results show that Lap Band is a
very good surgical treatment for
superobese patients, without great
complications and with a very good
result on weight lost and resolution
of the comorbid diseases
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