Balsiger B M, Kennedy F P, Abu-Lebdeh H S, Collazo-Clavell M, Jensen M D, O'Brien T, Hensrud D D, Dinneen S F, Thompson G B, Que F G, Williams D E, Clark M M, Grant J E, Frick M S, Mueller R A, Mai J L, Sarr M G
Division of Gastroenterologic and General Surgery, Mayo Clinic, Rochester, Minn. 55905, USA.
Mayo Clin Proc. 2000 Jul;75(7):673-80. doi: 10.4065/75.7.673.
To determine prospectively the results of Roux-en-Y gastric bypass (RYGB) used as the primary weight-reducing operation in patients with medically complicated ("morbid") obesity. The RYGB procedure combines the advantages of a restrictive physiology (pouch of 10 mL) and a "dumping physiology" for high-energy liquids without requiring an externally reinforced (banded) stoma.
Between April 1987 and December 1998, a total of 191 consecutive patients with morbid obesity (median weight, 138 kg [range, 91-240 kg]; median body mass index, 49 kg/m2 [range, 36-74 kg/m2]), all of whom had directly weight-related morbidity, underwent RYGB and prospective follow-up.
Hospital mortality was 0.5% (1/191), and hospital morbidity occurred in 10.5% (20/191). Good long-term weight loss was achieved, and patients adapted well to the required new eating habits. The mean +/- SD weight loss at 1 year after operation (113 patients) was 52 +/- 1 kg or 68% +/- 2% of initial excess body weight. By 3 years postoperatively (74 patients), weight loss was still 66% +/- 2% of excess body weight. Overall, 53 (72%) of 74 patients had achieved and maintained a weight loss of 50% or more of their preoperative excess body weight 3 years after the operation. In addition, only 1 (1%) of 98 patients had persistent postoperative vomiting 1 or more times per week.
We believe that RYGB is a safe, effective procedure for most patients with morbid obesity and thus may be the current procedure of choice in patients requiring bariatrics++ surgery for morbid obesity.
前瞻性地确定 Roux-en-Y 胃旁路术（RYGB）作为患有内科复杂疾病（“病态”）肥胖患者的主要减重手术的效果。RYGB 手术结合了限制性生理机能（10 mL 的胃囊）和针对高能液体的“倾倒生理机能”的优点，且无需外部强化（带环）造口。
在 1987 年 4 月至 1998 年 12 月期间，共有 191 例连续的病态肥胖患者（体重中位数为 138 kg[范围为 91 - 240 kg]；体重指数中位数为 49 kg/m²[范围为 36 - 74 kg/m²]），所有患者均有直接与体重相关的疾病，接受了 RYGB 手术并进行前瞻性随访。
医院死亡率为 0.5%（1/191），医院发病率为 10.5%（20/191）。实现了良好的长期体重减轻，患者对所需的新饮食习惯适应良好。术后 1 年（113 例患者）平均±标准差体重减轻为 52±1 kg，或为初始超重体重的 68%±2%。术后 3 年（74 例患者），体重减轻仍为超重体重的 66%±2%。总体而言，74 例患者中有 53 例（72%）在术后 3 年实现并维持了体重减轻达到或超过术前超重体重的 50%。此外，98 例患者中只有 1 例（1%）术后每周持续呕吐 1 次或更多次。
我们认为 RYGB 对大多数病态肥胖患者是一种安全、有效的手术，因此可能是需要进行病态肥胖减重手术的患者当前的首选手术。
