Victorzon Mikael, Tolonen Pekka
Department of Gastrointestinal Surgery, Vaasa Central Hospital, Vaasa, Finland.
Dig Surg. 2002;19(5):354-7; discussion 358. doi: 10.1159/000065839.
BACKGROUND/AIMS: Morbid obesity is a rapidly increasing health risk in most industrialized countries. Unfortunately, conservative treatment methods will fail in the long run in almost 100% of patients. Today, long-lasting success can only be achieved by operative treatments. Laparoscopic gastric banding has the general benefits of minimally invasive techniques is relatively easy to perform and can be reversed or changed to any other operation aiming at weight loss, if necessary. We report here our primary and intermediate outcome of Laparoscopic Adjustable Gastric Banding (LAGB).
Since 1996-2001 we have treated 110 (87 women, 23 men) morbidly obese patients with the Swedish Adjustable Gastric Band (SAGB). Median age (range) of the patients was 42 years (21-64), and preoperative median body mass index (BMI, kg/m(2)) (range) was 44 (35-66). Most of the patients suffered from obesity related co-morbidities.
At a median follow-up of 27 months, mean weight loss was 30 kg, mean excess weight loss (range) 52% (11-108%), and median (range) BMI 34 (24-46). Reoperations due to band slippage (3 patients), band erosion (2 patients), infection (1 patient), and leakage of the band or the filling system (5 patients) have been necessary in 11 (10%) patients so far. Median postoperative hospital stay (range) was 3 days (2-53). There was no mortality. Immediate postoperative morbidity was 9%. More than 50% of the patients had signs of mild erosive gastroesophageal reflux disease during routine endoscopic follow-up 3 years after the operation.
Weight loss following LAGB is generally good and complications few, at least in the short term. However, technical problems with the band causes morbidity and reoperations in a number of patients. Despite this fact, we think the LAGB operation is the best 'first' operation in the treatment of morbid obesity, although long-term results are not yet available.
背景/目的：在大多数工业化国家，病态肥胖正成为一个迅速增长的健康风险因素。不幸的是，保守治疗方法从长远来看几乎会使100%的患者治疗失败。如今，只有通过手术治疗才能取得持久的成效。腹腔镜胃束带术具有微创技术的一般优点，操作相对容易，如有必要，还可以逆转或改为任何其他旨在减肥的手术。在此，我们报告腹腔镜可调节胃束带术（LAGB）的主要和中期结果。
自1996年至2001年，我们使用瑞典可调节胃束带（SAGB）治疗了110例病态肥胖患者（87名女性，23名男性）。患者的年龄中位数（范围）为42岁（21 - 64岁），术前体重指数（BMI，kg/m²）中位数（范围）为44（35 - 66）。大多数患者患有与肥胖相关的合并症。
在中位随访27个月时，平均体重减轻30千克，平均超重减轻（范围）52%（11 - 108%），BMI中位数（范围）为34（24 - 46）。迄今为止，11例（10%）患者因束带滑脱（3例）、束带侵蚀（2例）、感染（1例）以及束带或填充系统渗漏（5例）而需要再次手术。术后住院时间中位数（范围）为3天（2 - 53天）。无死亡病例。术后即刻发病率为9%。超过50%的患者在术后3年的常规内镜随访中出现轻度糜烂性胃食管反流病的症状。
至少在短期内，LAGB术后的体重减轻情况总体良好，并发症较少。然而，束带的技术问题导致一些患者出现发病情况并需要再次手术。尽管如此，我们认为LAGB手术是治疗病态肥胖的最佳“首选”手术，尽管尚无长期结果。
