Kreitz Keith, Rovito Peter F
Department of Surgery, Lehigh Valley Hospital, Allentown, PA, USA.
Arch Surg. 2003 Jul;138(7):707-9; discussion 710. doi: 10.1001/archsurg.138.7.707.
Laparoscopic Roux-en-Y gastric bypass is a safe and effective procedure in patients with a body mass index (BMI; calculated as weight in kilograms divided by the square of height in meters) of 70 or greater.
A retrospective analysis of patients with a BMI of 70 or greater who underwent laparoscopic Roux-en-Y gastric bypass by a single surgeon.
A university-affiliated community hospital in Allentown, Pa.
A nonconsecutive series of 9 patients with a BMI of 70 or greater who met traditional criteria for a bariatric procedure.
Laparoscopic approach to Roux-en-Y gastric bypass with stapled anastomoses.
Patient medical records were reviewed for length of stay, complications, operative time, comorbidities, and weight loss. Seven patients were women and 2 were men. Comorbidities included dyspnea on exertion, peripheral edema, arthritis, sleep apnea, hypertension, diabetes mellitus, asthma, hypothyroidism, gastroesophageal reflux disease, peptic ulcer disease, and heart disease. Eight of 9 procedures were successfully completed laparoscopically. One patient was converted to an open procedure. One patient developed a marginal ulcer postoperatively. No other complications occurred. Operative time ranged from 122 to 330 minutes (mean, 203 minutes). Length of stay averaged 1.2 days. Overall weight loss was 49% of excess body weight at 1 year after surgery.
Laparoscopic Roux-en-Y gastric bypass is safe and effective in patients with a BMI of 70 or greater.
对于体重指数（BMI；计算方法为体重（千克）除以身高（米）的平方）达到或超过70的患者，腹腔镜Roux-en-Y胃旁路手术是一种安全有效的手术方法。
对由一名外科医生实施腹腔镜Roux-en-Y胃旁路手术的BMI达到或超过70的患者进行回顾性分析。
宾夕法尼亚州阿伦敦一家大学附属社区医院。
一组非连续性的9例BMI达到或超过70且符合减肥手术传统标准的患者。
采用腹腔镜方法进行Roux-en-Y胃旁路手术并使用吻合器进行吻合。
查阅患者病历以了解住院时间、并发症、手术时间、合并症及体重减轻情况。7例为女性，2例为男性。合并症包括劳力性呼吸困难、外周水肿、关节炎、睡眠呼吸暂停、高血压、糖尿病、哮喘、甲状腺功能减退、胃食管反流病、消化性溃疡病及心脏病。9例手术中有8例成功通过腹腔镜完成。1例患者转为开腹手术。1例患者术后出现边缘溃疡。未发生其他并发症。手术时间为122至330分钟（平均203分钟）。住院时间平均为1.2天。术后1年总体体重减轻为超重体重的49%。
对于BMI达到或超过70的患者，腹腔镜Roux-en-Y胃旁路手术安全有效。
