Angrisani L, Favretti F, Furbetta F, Iuppa A, Doldi S B, Paganelli M, Basso N, Lucchese M, Zappa M, Lesti G, Capizzi F D, Giardiello C, Di Lorenzo N, Paganini A, Di Cosmo L, Veneziani A, Lacitignola S, Silecchia G, Alkilani M, Forestieri P, Puglisi F, Gardinazzi A, Toppino M, Campanile F, Marzano B, Bernante P, Perrotta G, Borrelli V, Lorenzo M
Italian Group for Lap-Band, c/o Fondazione IDIS, Città della Scienza, via Coroglio 156, 80124 Naples, Italy.
Obes Surg. 2004 Mar;14(3):415-8. doi: 10.1381/096089204322917963.
The Lap-Band System is the most common bariatric operation world-wide. Current selection criteria do not include patients with BMI < or = 35. We report the Italian multicentre experience with BMI < or = 35 kg/m(2) over the last 5 years.
Data were obtained from 27 centres involved in the Italian Collaborative Study Group for Lap-Band System. Detailed information was collected on a specially created electronic data sheet (MS Access 2000) on patients operated in Italy since January 1996. Items regarding patients with BMI < or = 35 were selected. Data were expressed as mean +/- SD except as otherwise indicated.
225 (6.8%) out of 3,319 Lap-Band patients were recruited from the data-base. 15 patients, previously submitted to another bariatric procedure (BIB =14; VBG= 1) were excluded. 210 patients were eligible for study (34M/176F, mean age 38.19+/-11.8, range 17-66 years, mean BMI 33.9+/-1.1, range 25.1-35 kg/m(2), mean excess weight 29.5+/-7.1, range 8-41). 199 comorbidities were diagnosed preoperatively in 55/210 patients (26.2%). 1 patient (0.4%) (35 F) died 20 months postoperatively from sepsis following perforation of dilated gastric pouch. There were no conversions to laparotomy. Postoperative complications presented in 17/210 patients (8.1%). Follow-up was obtained at 6, 12, 24, 36, 48 and 60 months. At these time periods, mean BMI was 31.1+/-2.15, 29.7+/-2.19, 28.7+/-3.8, 26.7+/-4.3, 27.9+/-3.2, and 28.2+/-0.9 kg/m(2) respectively. Co-morbidities completely resolved 1 year postoperatively in 49/55 patients (89.1%). At 60 months follow-up, only 1 patient (0.4%) has a BMI >30.
Although surgical indications for BMI < or = 35 remain questionable, the Lap-Band in this study demonstrated that all but 1 patient achieved normal weight, and most lost their co-morbidities with a very low mortality rate.
可调节胃束带系统是全球最常见的减肥手术。目前的选择标准不包括体重指数（BMI）≤35的患者。我们报告了意大利多中心在过去5年中对BMI≤35kg/m²患者的治疗经验。
数据来自参与意大利可调节胃束带系统协作研究组的27个中心。自1996年1月起在意大利接受手术的患者的详细信息收集在专门创建的电子数据表（MS Access 2000）上。选取了BMI≤35患者的相关项目。数据以均值±标准差表示，另有说明的除外。
从数据库中选取了3319例可调节胃束带手术患者中的225例（6.8%）。排除了15例先前接受过其他减肥手术的患者（14例接受胃内水球植入术；1例接受垂直束带胃成形术）。210例患者符合研究条件（34例男性/176例女性，平均年龄38.19±11.8岁，范围17 - 66岁，平均BMI 33.9±1.1，范围25.1 - 35kg/m²，平均超重29.5±7.1，范围8 - 41）。55/210例患者（26.2%）术前诊断出199种合并症。1例患者（0.4%）（35岁女性）术后20个月因扩张胃囊穿孔并发败血症死亡。无中转开腹手术。17/210例患者（8.1%）出现术后并发症。在6、12、24、36、48和60个月时进行随访。在这些时间段，平均BMI分别为31.1±2.15、29.7±2.19、28.7±3.8、26.7±4.3、27.9±3.2和28.2±0.9kg/m²。49/55例患者（89.1%）术后1年合并症完全缓解。在60个月随访时，只有1例患者（0.4%）BMI＞30。
尽管BMI≤35的手术指征仍存在疑问，但本研究中的可调节胃束带手术表明，除1例患者外所有患者均达到正常体重，且大多数患者消除了合并症，死亡率极低。
