università degli studi di torino chirurgia generale ii (direttore prof. m. morino) mauro toppino...

Università degli Studi di TorinoUniversità degli Studi di TorinoChirurgia Generale IIChirurgia Generale II(Direttore Prof. M. Morino)(Direttore Prof. M. Morino)

Mauro ToppinoMauro Toppino

Bendaggio gastrico :Bendaggio gastrico :Dati Registro S.I.C.OB.Dati Registro S.I.C.OB.

Bendaggio gastrico :Bendaggio gastrico :Dati Registro S.I.C.OB.Dati Registro S.I.C.OB.

ACOIACOIMontecatini Terme, 2005Montecatini Terme, 2005

Italian Registry

11923interventions

from January 1996

Italian Registry

11923interventions

from January 1996

I.B.S.R. (Mason Registry)14.641 interventions in 10 years

I.B.S.R. (Mason Registry)14.641 interventions in 10 years

Favretti - VicenzaAdorni - ParmaDella Valle - Reggio E.Melotti - ModenaAmenta - BolognaCapizzi – BolognaTuricchia - RavennaScopinaro - GenovaDePaoli - GenovaFalchero – AlbengaLucchese - FirenzePalandri - PistoiaFurbetta - PisaAnselmino – PisaDi Cosmo - SienaGaggiotti - AnconaBoni – Foligno

Parini - AostaMorino – TorinoNanni - VercelliDoldi - MilanoPaganelli – MilanoLattuada – MilanoBertoncini - MagentaVassallo - PaviaDella Valle – StradellaSacco – BergamoSalerni - BresciaGardinazzi – BresciaBoscarino – DesenzanoBottani – MortaraPizzi – MonzaBruni – MantovaCampo - Castiglione St.Baggio – Verona

Basso – RomaTacchino - RomaBertoldi - RomaBadiali - RomaLesti – LancianoCampanile – Civita C.Forestieri - NapoliAngrisani – NapoliPorcini – NapoliGiardiello – CasoriaPuglisi – BariAlkilani - Reggio C.Bajardi - PalermoNoya – Sassari + Perugia

49 Registry Contributors49 Registry Contributors49 Registry Contributors49 Registry Contributors

11923 Interventions

• ASGB ASGB 53245324 (44.7 %)(44.7 %)

• VBGVBG 3794 3794 (31.8 %)(31.8 %)

• BPDBPD 18491849 (15.5 %)(15.5 %)

• GBPGBP 647 647 (5.4 %)(5.4 %)

• BIBBIB 199199 (1.7 %)(1.7 %)

• n.a.GB n.a.GB 5555 (0.5 %)(0.5 %)

• Pacing Pacing 25 25 (0.2 %)(0.2 %)

• Others Others 3030 (0.2 %)(0.2 %)

Different Technique Increasen.

1270

3167

1444

1961

544

1197

37

390

17 158

0

500

1000

1500

2000

2500

3000

3500

ASGB VBG BPD GBP BIB

1996-2000

2000-2004

674

3529

346851

1154

0269

0

500

1000

1500

2000

2500

3000

3500

4000

ASGB VBG BPD GBP

1996-19991999-2004

Laparoscopic Procedures

Favretti - VicenzaAdorni - ParmaCapizzi – BolognaTuricchia - RavennaDePaoli - GenovaLucchese - FirenzeFurbetta - PisaAnselmino – PisaDi Cosmo - SienaGaggiotti - Ancona

Morino – TorinoDoldi - MilanoPaganelli – MilanoLattuada – MilanoBertoncini - MagentaVassallo - PaviaDella Valle – StradellaSacco – BergamoSalerni - BresciaGardinazzi – BresciaBoscarino – DesenzanoBottani – MortaraPizzi – MonzaBaggio – Verona

Basso – RomaBertoldi - RomaLesti – LancianoCampanile – Civita C.Forestieri - NapoliAngrisani – NapoliPorcini – NapoliGiardiello – CasoriaPuglisi – BariAlkilani - Reggio C.

34 Registry Contributors34 Registry Contributorsfor LASGBfor LASGB

34 Registry Contributors34 Registry Contributorsfor LASGBfor LASGB

Laparoscopy 5143 (96.6%)Laparoscopy 5143 (96.6%)

ASGB5324

Open 181 (3.4%)Open 181 (3.4%)

Conversions (1.4%)Conversions (1.4%)

Heliogast 413 8.2%Heliogast 413 8.2%

MidBand 526MidBand 526 7.7% 7.7%

Swedish Band 508Swedish Band 508 10 % 10 %

ASGBDifferent Bands

Lap-Band 3596Lap-Band 3596 71.3% 71.3%

Heliogast Heliogast 6 6

MidBand MidBand 4 4

Swedish Band Swedish Band 8 8

ASGBDifferent Bands and

Centers

Lap-Band Lap-Band 22 22

Pre operative BMI

ASGB VBG BPG GBP

43.1 44.8 48.9 48.8

Operative time

ASGBVBGopen

86.8 89

VBGlap

BPDopen

GBPopen

GBPlap

110 196 197 185

Conversions to open

ASGB VBG BPD GBP

1.4 4.3 12.2 1.7

Postop stay

ASGBVBGopen

2.5 6.6

VBGlap

BPDopen

GBPopen

GBPlap

6.4 9.5 9.1 9.1

Operative mortality32 / 11923 (0.27%)

• ASGB ASGB 5 / 53245 / 5324 (0.1 %)(0.1 %)

• VBGVBG 7 / 3794 7 / 3794 (0.2 %)(0.2 %)

• BPDBPD 19 / 184919 / 1849 ( 1 %)( 1 %)

• GBPGBP 1 / 647 (0.2 %) 1 / 647 (0.2 %)

Early Complications

1,6

8,4

6,7

12,4

16,6

13,9

ASGB VBGopen

VBGlap

BPDopen

GBPopen

GPBlap

%%

Results on weight loss (ASGB)

39,942,2

5y (306 p) 8y (11 p)

EWL%EWL%

Results on weight loss (VBG)

59,352,4

20

25

30

35

40

45

50

55

60

65

70

5y (309 p) 8y (78 p)

EWL%EWL%

Results on weight loss (BPD)

67,370,5

5y (246 p) 8y (42 p)

EWL%EWL%

Late complications (% reinterventions)

10,0

3,4

5,3

2,5

ASGB VBG BPD GBP

%%

6.3 %6.3 %major complmajor compl..

S.I.C.OB. RegistryS.I.C.OB. RegistryLASGBLASGB

Excellent results on early complications,operative time, post-operative stay

Good results on weight loss(less than other bariatric techniques)

Initial high rate of late complications(at present widely decreased)

ConclusionsConclusions