Cordera Fernando, Mai Jane L, Thompson Geoffrey B, Sarr Michael G
Department of Surgery, Mayo Clinic, Rochester, MN 55905, USA.
Surgery. 2004 Oct;136(4):731-7. doi: 10.1016/j.surg.2004.05.055.
In 1991, the National Institutes of Health sanctioned 2 operations for treatment of morbid obesity: vertical banded gastroplasty (VBG) and Roux-en-Y gastric bypass (RYGB). Long-term results with VBG are disappointing. We wondered whether patients who had "adapted" to the VBG anatomy and had regained weight would lose weight after conversion to RYGB.
We reviewed data on patients undergoing conversion of VBG to RGYB.
Fifty-four patients (mean body mass index [BMI] of 46 kg/m2 [range, 36-66]) underwent standard (48 patients) or distal (malabsorptive) (6 patients) RYGB. There were no perioperative deaths; postoperative morbidity delaying discharge occurred in 7 patients (13%). Follow-up (complete in 51 patients, x=6.1 years) was obtained by mail questionnaires and patient contact. Mean BMI decreased to 35 kg/m 2 (range, 22-47), and 59% of the patients with >1 year follow-up had a BMI <35 kg/m2 . The number of patients requiring positive pressure oxygen for sleep apnea decreased by half; most patients discontinued or decreased the number of medications treating weight-related comorbidities. At last follow-up, 90% of patients were satisfied subjectively with the results.
Conversion of VBG to RYGB is safe and provides weight loss, improved quality of life, and reversal of weight related comorbidities.
1991年，美国国立卫生研究院批准了两种治疗病态肥胖的手术：垂直束带胃成形术（VBG）和Roux-en-Y胃旁路术（RYGB）。VBG的长期效果令人失望。我们想知道那些已经“适应”VBG解剖结构并体重反弹的患者在转为RYGB后是否会减重。
我们回顾了接受VBG转为RYGB手术患者的数据。
54例患者（平均体重指数[BMI]为46kg/m²[范围36 - 66]）接受了标准（48例患者）或远端（吸收不良型）（6例患者）RYGB手术。围手术期无死亡病例；7例患者（13%）出现了延迟出院的术后并发症。通过邮寄问卷和与患者联系进行随访（51例患者随访完整，平均随访时间x = 6.1年）。平均BMI降至35kg/m²（范围22 - 47），随访超过1年的患者中有59%的BMI < 35kg/m²。因睡眠呼吸暂停需要正压给氧的患者数量减少了一半；大多数患者停止或减少了治疗与体重相关合并症的药物数量。在最后一次随访时，90%的患者对结果主观上感到满意。
VBG转为RYGB手术是安全的，能实现减重、改善生活质量并逆转与体重相关的合并症。
