Just last week, I wrote about the poor outcomes from studies on a new minimally-invasive approach to gastric stapling, via the oral route. Now, I want to call your attention to an article published last week in the Archives of Surgery that raises questions about the safety and long-term success of current gastric banding procedures. The study, conducted in Belgium was headed by Dr. Jacques Himpens, looked at outcomes in patients who had laparoscopic gastric banding procedures performed between 1994-1997. The study results were alarming; in about 30% of patients, the bands eroded and 60% required additional surgery. Also, most patients were still quite overweight; patients had ended up losing well less than half of their excess weight. The investigators concluded that gastric banding procedures “result in relatively poor long-term outcomes.” The study was limited in that data were available on only about 60% of the total number of patients but it represents one of the few studies out there with long-term data on gastric banding procedures. Of course, one could take a positive approach to the data- most patients were quite a bit less heavy than they were before the procedure, and about 60% of the patients expressed satisfaction with the surgery. Anyway, these data illustrate a principle in medicine that I have often written about- one must weight risks vs. benefits for any treatment, be it growth hormone injections or gastric banding. It is the unknown risks that pose the greatest dilemma in trying to decide if a proposed therapy is a good idea.
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