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Year : 2023  |  Volume : 2  |  Issue : 1  |  Page : 3-12

Long- and very long-term unfavorable outcomes of the laparoscopic adjustable gastric band in the surgical approach of morbid obesity: A systematic review and meta-analysis

1 Department of Gastrointestinal Surgery, Marilia School of Medicine, Marília, Brazil
2 Rede D'or/São Luis, Rio de Janeiro, Brazil
3 Department of Surgery, State University of Londrina, Londrina, Brazil
4 Caetano Marchesini Clinic, Curitiba, Brazil
5 Gastro MT, Cuiabá, Brazil
6 Brazilian Medical Association Guideline Group, São Paulo, Brazil
7 University of São Paulo, São Paulo, Brazil

Correspondence Address:
Dr. Eduardo Lemos de Souza Bastos
Department of Gastrointestinal Surgery, Marilia School of Medicine, Marília
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jbs.jbs_10_22

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Aim: The aim is to assess the long- and very long-term rate of unfavorable outcomes associated with the laparoscopic adjustable gastric band (LAGB) in morbid obesity. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-analyses statement was used in this systematic review. The search for evidence was performed in the MEDLINE (PubMed), EMBASE, LILACS, Clinical Trials, and Google Scholar databases from the inception to October 2021. The main eligibility criteria were obese adult undergoing LAGB, unfavorable outcomes, and a minimum follow-up of 4 years. Outcomes were aggregated using the Comprehensive Meta-Analysis software for noncomparative studies, and the quality of evidence was sorted. Heterogeneity was assumed when I2 >50%. Because of expected differences among retrieved studies and several uncontrolled variables, the random-effects model was used to perform a proportional meta-analysis. Results: Data on 23,916 unfavorable outcomes were extracted from 28 studies (N = 107,370 patients). The use of the LAGB may be related to a rate of around 30% for reoperation (95% confidence interval [CI] = 20.4%–41.4%), 18% for band removal (95% CI = 13.3%–24.5%), 12% for nonresponse (95% CI = 5.2%–23.8%), 8% for port/tube complications (95% CI = 5.1%–13.6%), 7% for slippage/prolapse (95% CI = 5.3%–9.7%), 6% for pouch enlargement (95% CI = 3.4%–9.9%), and 3% for erosion/migration (95% CI = 2.0%–4.3%) in the long- and very long-term follow-up. However, the quality of evidence was considered very low. Conclusion: Despite the very low quality of evidence, LAGB was associated with not negligible rates of unfavorable outcomes in long- and very long-term follow-up.

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