Miller K, Hell E
Second Surgical Department, Landeskrankenanstalten Salzburg, Austria.
Obes Surg. 1999 Apr;9(2):183-7. doi: 10.1381/096089299765553467.
A body mass index of > or =40 kg/m2 represents clinically severe obesity and warrants operative treatment if requested. The adjustable silicone gastric band and the Swedish adjustable gastric band are recently produced laparoscopic gastric restrictive devices. The aim of this study was to assess all complications linked to both the available gastric bands in a long-term follow-up.
In a prospective study, the effects, complications, and outcomes of this procedure were analyzed. The complications found were divided into early and general complications, and complications correlated to the bands. The technique of laparoscopic adjustable gastric banding is described. Follow-up was performed by the operating team.
Between July 1994 and August 1998, the authors operated on 158 patients and performed 102 adjustable silicone gastric bandings and 54 Swedish adjustable gastric bandings. The mean age at surgery was 36 years (range 17-72). The mean preoperative weight was 136 kg (89-230). Of 158 patients who underwent laparoscopic procedures, 156 (98%) could be followed up (mean 28 months; duration of follow-up, 6 weeks to 46 months). In early postoperative complications that required operation, one trocar wound hematoma (0.6%) and one wound infection of the port site (0.6%) were observed. The late complications that required reoperation were two pouch dilatations (1.3%), three band leakages (2%), one band migration (0.6%), and one late infection of the port (0.6%). A debanding operation was necessary in one patient because of esophageal dysmotility disorder. No early or late postoperative mortality was registered. The overall reoperation rate is currently about 7%.
The operation is safe and effective. Moreover, adjustable gastric banding is fully reversible and is adjustable to the patient's needs. This study verifies the importance of correct operating technique. The authors' study and experience clearly indicate that laparoscopic adjustable gastric banding is an attractive alternative in the surgical treatment of morbid obesity.
体重指数≥40kg/m²代表临床重度肥胖，若有需求则需手术治疗。可调节硅胶胃束带和瑞典可调节胃束带是近期生产的腹腔镜胃限制性器械。本研究的目的是在长期随访中评估与这两种现有胃束带相关的所有并发症。
在一项前瞻性研究中，分析了该手术的效果、并发症及结果。所发现的并发症分为早期和一般并发症，以及与束带相关的并发症。描述了腹腔镜可调节胃束带术的技术。由手术团队进行随访。
1994年7月至1998年8月期间，作者为158例患者实施了手术，其中102例进行了可调节硅胶胃束带术，54例进行了瑞典可调节胃束带术。手术时的平均年龄为36岁（范围17 - 72岁）。术前平均体重为136kg（89 - 230kg）。158例行腹腔镜手术的患者中，156例（98%）获得随访（平均28个月；随访时间为6周至46个月）。术后早期需要手术处理的并发症中，观察到1例套管针伤口血肿（0.6%）和1例端口部位伤口感染（0.6%）。需要再次手术的晚期并发症有2例胃囊扩张（1.3%）、3例束带渗漏（2%）、1例束带移位（0.6%）和1例端口晚期感染（0.6%）。1例患者因食管运动障碍疾病需要进行拆带手术。术后无早期或晚期死亡病例。目前总体再次手术率约为7%。
该手术安全有效。此外，可调节胃束带术完全可逆，可根据患者需求进行调节。本研究证实了正确手术技术的重要性。作者的研究和经验清楚地表明，腹腔镜可调节胃束带术是治疗病态肥胖手术中的一种有吸引力的选择。
