MacLean L D, Rhode B M, Nohr C W
Department of Surgery, Royal Victoria Hospital and McGill University, 1402 80 Berlioz, Montreal, Quebec H3E 1N9, Canada.
J Gastrointest Surg. 2001 Sep-Oct;5(5):525-30. doi: 10.1016/s1091-255x(01)80091-3.
The aim of this study was to determine whether longer limb length improved results of gastric bypass in patients who were morbidly obese (body mass index <50 kg/m(2)) or superobese (body mass index >50 kg/m(2). A total of 242 patients were followed for a mean of 5.5 years. The standard operation was a Roux-en-Y gastric bypass with a 40 cm Roux limb and a 10 cm afferent limb. The long-limb operation had a 100 cm Roux limb and a 100 cm afferent limb. Morbidly obese patients did not benefit from a long-limb bypass. The final body mass index was 28.6 +/- 4.7 kg/m(2) in the short-limb group and 28.5 +/- 3.8 kg/m(2) in the long-limb group. The superobese patients did benefit from a long-limb bypass. Final body mass index was 35.8 +/- 6.7 kg/m(2) in the short-limb patients and 32.7 +/- 5.1 in the long-limb patients (P = 0.049). A subgroup of 20 patients, all of whom had a body mass index greater than 60 kg/m(2), benefited the most from long-limb bypass. No macronutritional side effects unique to the long-limb bypass were encountered.
本研究的目的是确定在病态肥胖（体重指数<50kg/m²）或超级肥胖（体重指数>50kg/m²）患者中，肢体长度更长是否能改善胃旁路手术的效果。总共242名患者被随访了平均5.5年。标准手术是 Roux-en-Y 胃旁路术，Roux 袢长40cm，输入袢长10cm。长袢手术的 Roux 袢长100cm，输入袢长100cm。病态肥胖患者未从长袢旁路手术中获益。短袢组的最终体重指数为28.6±4.7kg/m²，长袢组为28.5±3.8kg/m²。超级肥胖患者确实从长袢旁路手术中获益。短袢患者的最终体重指数为35.8±6.7kg/m²，长袢患者为32.7±5.1（P = 0.049）。20名体重指数均大于60kg/m²的患者亚组从长袢旁路手术中获益最大。未遇到长袢旁路手术特有的大量营养素副作用。
