Hesse U J, Berrevoet F, Ceelen W, Mortele K, Cardon A, Troisi R, Pattyn P
Department of Surgery, Ghent University Hospital, Gent, Belgien.
Chirurg. 2001 Jan;72(1):14-8. doi: 10.1007/s001040051261.
Two different adjustable silicone gastric bandings were laparoscopically applied and compared regarding per- and postoperative complications and successful weight loss.
A total of 120 consecutive patients received a laparoscopic adjustable gastric banding and were prospectively documented. In the learning phase (LP) 50 patients were treated with an Adjustable Silicone Gastric Banding (ASGB, Bioenterics) using an intragastric balloon calibration technique according to Belachew. Group I (n = 29) received the same band using a surgical technique with tunneling behind the oesophagus towards His' angle, while the second group (n = 41) received a Swedish Adjustable Gastric Banding (SAGB), using the same technique as in group I. A BMI of > 35, complications secondary to obesity and failed diets were the indication for the operation. Thirty patients were male, 90 female, with a mean age of 37 years (18-60).
In the LP 8 patients had to be reoperated (16%) for band slippage and/or pouch dilatation, in group I 6 (19%) and in group II 1 (3%) (P = 0.02, II vs I). The mean hospital stay was 3.7 +/- 0.5, 3.4 +/- 0.8 and 3.3 +/- 0.4 days in LP, I und II, respectively. LONG-TERM RESULTS: After a mean of 24 months (19-42) the loss of body weight was 8.4 kg after 3, 13.9 kg after 6, 22.1 kg after 12 and 27.8 kg after 18 months in the LP. In group I after a mean of 14 months (12-19) 10.3 kg after 3, 18.7 kg after 6, 24.8 kg after 12 months. In group II after a mean of 10 months (6-16) the loss of body weight was 7.9 kg after 3 and 19.4 kg after 6 months.
In our experience it appears that the SAGB is easy to handle and less prone to complications such as dysphagia and slipping, probably due to good fixation of the band due to its width. A prospective randomized trial is warranted.
通过腹腔镜应用两种不同的可调节硅胶胃束带，并比较其围手术期和术后并发症以及体重减轻情况。
共有120例连续患者接受了腹腔镜可调节胃束带手术，并进行了前瞻性记录。在学习阶段（LP），50例患者使用可调节硅胶胃束带（ASGB，Bioenterics），根据Belachew的方法采用胃内球囊校准技术进行治疗。第一组（n = 29）采用相同的束带，通过在食管后方朝向His角的隧道技术进行手术，而第二组（n = 41）接受瑞典可调节胃束带（SAGB），采用与第一组相同的技术。手术指征为BMI > 35、肥胖继发并发症以及节食失败。患者中30例为男性，90例为女性，平均年龄37岁（18 - 60岁）。
在学习阶段，8例患者（16%）因束带滑脱和/或胃囊扩张需要再次手术，第一组6例（19%），第二组1例（3%）（P = 0.02，第二组与第一组相比）。学习阶段、第一组和第二组的平均住院时间分别为3.7 ± 0.5天、3.4 ± 0.8天和3.3 ± 0.4天。
平均24个月（19 - 42个月）后，学习阶段患者在3个月时体重减轻8.4 kg，6个月时减轻13.9 kg，12个月时减轻22.1 kg，18个月时减轻27.8 kg。第一组平均14个月（12 - 19个月）后，3个月时体重减轻10.3 kg，6个月时减轻18.7 kg，12个月时减轻24.8 kg。第二组平均10个月（6 - 16个月）后，3个月时体重减轻7.9 kg，6个月时减轻19.4 kg。
根据我们的经验，SAGB似乎易于操作，且较少发生吞咽困难和束带滑脱等并发症，这可能是由于束带宽度使其固定良好。有必要进行一项前瞻性随机试验。
