Lee W J, Lai I R, Huang M T, Wu C C, Wei P L
Department of Surgery, En-Chu Kong Hospital and National Taiwan University Hospital, Taipei.
Surg Laparosc Endosc Percutan Tech. 2001 Feb;11(1):9-13.
Vertical banded gastroplasty (VBG) is an effective treatment for morbid obesity. Recent advancement in laparoscopic surgery has made laparoscopic VBG possible. The authors compared retrospectively the outcomes of laparoscopic VBG versus open VBG in patients with morbid obesity. From June 1998 to April 1999, 100 patients (18 men, 82 women; average age, 32.6 years) underwent laparoscopic VBG, and 40 patients (7 men, 33 women; average age, 28.8 years) underwent conventional open VBG. The two groups were similar regarding sex, age, and body mass index distribution. Mean surgical time, blood loss estimate, duration of postoperative recovery, analgesic usage, complications, and weight reduction were compared among the two groups. Laparoscopic VBG was successful in 99 (99%) of the 100 patients. Mean surgical time was longer in duration for the laparoscopic VBG group than it was for the open VBG group (173 vs. 101 minutes, P < 0.01). The laparoscopic VBG group had earlier flatus passage (1.9 vs. 2.6 days; P < 0.01), less usage of analgesics (meperidine 50 mg/unit; 0.9 vs. 2.3 units; P < 0.01), and a shorter postoperative hospital stay (3.7 vs. 6.0 days; P < 0.01). Estimated blood loss, surgical complication rate, and weight reduction were similar among the two groups. Although laparoscopic VBG required a longer surgical time and was technically more demanding, it resulted in shorter recovery time, less analgesic use, and less severe physical discomfort. The authors' findings show that the two methods were approached safely equally.
垂直束带胃成形术（VBG）是治疗病态肥胖的一种有效方法。腹腔镜手术的最新进展使得腹腔镜VBG成为可能。作者回顾性比较了病态肥胖患者腹腔镜VBG与开放性VBG的治疗效果。1998年6月至1999年4月，100例患者（18例男性，82例女性；平均年龄32.6岁）接受了腹腔镜VBG，40例患者（7例男性，33例女性；平均年龄28.8岁）接受了传统开放性VBG。两组在性别、年龄和体重指数分布方面相似。比较了两组的平均手术时间、估计失血量、术后恢复时间、镇痛药使用情况、并发症和体重减轻情况。100例患者中有99例（99%）腹腔镜VBG手术成功。腹腔镜VBG组的平均手术时间比开放性VBG组长（173分钟对101分钟，P<0.01）。腹腔镜VBG组排气时间更早（1.9天对2.6天；P<0.01），镇痛药使用量更少（哌替啶50mg/单位；0.9单位对2.3单位；P<0.01），术后住院时间更短（3.7天对6.0天；P<0.01）。两组的估计失血量、手术并发症发生率和体重减轻情况相似。虽然腹腔镜VBG需要更长的手术时间且技术要求更高，但它导致恢复时间更短、镇痛药使用更少且身体不适更轻。作者的研究结果表明，两种方法的安全性相当。
