Twenty-five case series studies were included in the review (15,775 patients). The mean number of patients per study was 631 (±486). The mean follow-up was 3.73 years (±2.4).
The incidence of erosions ranged from 0.23% to 32.65%.
Treatment of erosion: Two small case series studies suggested that delayed reinsertion was associated with lower a rate of re-erosion compared with immediate replacement. Two case series studies that used conversion to another bariatric procedure reported complications including wound infection, anastomotic leak and death. Few serious postoperative complications following erosion treatment, as well as few complications after band removal, gastric wall repair and replacement (whether immediate or delayed) were reported. Complications included wound infection, abdominal pain, and gastric fistula (17 studies).
Weight change after treatment of erosion: Weight loss was maintained following treatment for erosions across studies with patients who experienced erosion (mean percentage excess weight loss 50.34 (± 3.9%) at final follow-up. Significantly greater mean percent excess weight loss was found in studies with low rates of erosion (below 1.5 incidence) when compared with studies with high erosion rates (over 3%). When subdivided by treatment type, continuing weight loss was best in patients undergoing delayed replacement (48.7%) compared with immediate replacement (45.2%), conversion (41.4%), and explantation (40%). These results did not reach statistical significance.