Papasavas P K, Hayetian F D, Caushaj P F, Landreneau R J, Maurer J, Keenan R J, Quinlin R F, Gagné D J
Minimally Invasive Surgery, West Penn Allegheny Health System, 4800 Friendship Avenue, Pittsburgh, PA 15224, USA.
Surg Endosc. 2002 Dec;16(12):1653-7. doi: 10.1007/s00464-002-8531-5. Epub 2002 Sep 23.
Morbid obesity has been described as a continuing epidemic affecting a growing portion of our population. We report an outcome analysis of our early experience with laparoscopic Roux-en-Y gastric bypass (LRYGB) in the treatment of morbid obesity.
Two surgeons performed 116 consecutive LRYGBs at a single institution, creating a 25-ml pouch and a 90- to 150-cm Roux limb. The prospectively collected data included patient demographics, comorbidities, postoperative weight loss, and complications.
All eight conversions to an open procedure occurred early during the experience of the surgeons. The mean operating room time for the first 50 cases was 272 min, which decreased to 198 min with experience. The mean length of hospital stay was 3 days. There were 34 complications in 27 patients (23.3%), 14 of which (12%) required reoperation. At 18 months postoperatively, the patients had lost 77% of their excess weight, and their body mass index had decreased from a mean of 49.3 to 32.6 kg/m2. As a result of LRYGB, 25% of the patients were rendered completely free of any pharmacologic treatment for their preexisting comorbidities.
Although technically challenging, LRYGB can be performed safely with excellent long-term results. The mean operating room time and conversion rate improved with experience. As this study showed, LRYGB achieves an excellent rate of weight loss and improvement in preoperative comorbidities with a minimal length of hospital stay and an acceptable complication rate.
病态肥胖已被描述为一种持续蔓延的流行病，影响着越来越多的人群。我们报告了我们早期采用腹腔镜Roux-en-Y胃旁路术（LRYGB）治疗病态肥胖的结果分析。
两名外科医生在单一机构连续进行了116例LRYGB手术，制作了一个25毫升的胃囊和一个90至150厘米的Roux肠袢。前瞻性收集的数据包括患者人口统计学资料、合并症、术后体重减轻情况及并发症。
所有8例转为开放手术的情况均发生在外科医生经验积累的早期。前50例手术的平均手术室时间为272分钟，随着经验的积累，该时间降至198分钟。平均住院时间为3天。27例患者（23.3%）出现34例并发症，其中14例（12%）需要再次手术。术后18个月，患者减轻了77%的超重体重，体重指数从平均49.3降至32.6kg/m²。由于LRYGB手术，25%的患者在治疗先前存在的合并症时完全无需任何药物治疗。
尽管技术上具有挑战性，但LRYGB手术可以安全进行，并取得优异的长期效果。平均手术室时间和中转率随着经验的积累而改善。正如本研究所示，LRYGB手术实现了极高的体重减轻率，并改善了术前合并症，住院时间最短，并发症发生率可接受。
