Banded sleeve gastrectomy versus nonbanded sleeve gastrectomy: 3-year results of a retrospective cohort study

Introduction
Laparoscopic sleeve gastrectomy or nonbanded sleeve gastrectomy (NBSG) is nowadays the most commonly performed and known bariatric procedure for its safety and effectiveness, yet weight regain is still a long-term disadvantage. Banded sleeve gastrectomy is considered to be a restrictive operation. The authors aim to compare the results of both operations after a follow-up period of 3 years.
Methods
In this retrospective cohort, the authors reviewed all medical records of the Department of Bariatric Surgery at Ainshams University Hospital from January 2018 to December 2020. Forty patients were then divided into two groups: either laparoscopic banded sleeve gastrectomy (20 patients) or nonbanded laparoscopic sleeve gastrectomy (20 patients). The authors included all patients above 18 years old and excluded those who were below 18 years or over 60, had previous bariatric or gastrointestinal surgery, psychiatric contraindications, pregnancy, and other medical reasons for denying laparoscopy. Patients were followed postoperatively at 3, 6, 12, 24, and 36 months.
Results
During 3 years of follow-up, no patient was lost. Of 40 patients, 20 underwent laparoscopic BSG and 20 underwent NBSG. At 36 months, the BSG group had a significant BMI loss compared with the NBSG group, 20.30±2.8 and 23.9±4.2, respectively ( value 0.003). NBSG has less operative time (mean 41±4.2 min) compared with BSG (mean: 45.5±2.9 min). No difference is detected for postoperative reflux between BSG versus NBSG (=0.67). There was no significant difference in BMI loss between two groups during 3, 6, 12, and 24 months of follow-up.
Conclusion
This study suggests that BSG is more effective than NBSG in reducing BMI at 36 months. Future large-sample randomized trials are needed to compare the two surgeries regarding long-term postoperative complications and need for secondary operation. The authors recommend testing the application of the band around the upper third of the remaining stomach in reducing the postoperative reflux after banded sleeve gastrectomy.