Wong S K H, So W Y, Yau P Y P, Chan A K L, Lee S, Chan P N, Chow F C C, Chung S S C
Department of Surgery, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong.
Hong Kong Med J. 2005 Feb;11(1):20-9.
To evaluate the efficacy of laparoscopic adjustable gastric banding in the management of morbid obesity in a cohort of Chinese patients. DESIGN. Cohort study.
University teaching hospital, Hong Kong.
From August 2002 to September 2003, 10 patients (6 male, 4 female) with a median age of 34 years (range, 23-48 years) underwent laparoscopic adjustable gastric banding to treat morbid obesity. Considerable co-existing diseases were present in 90% of the cases. We instituted a team approach that allowed every patient to see our dietitian, physician, psychiatrist (if necessary), and surgeon prior to deciding on the procedure to be used.
Excessive body weight loss, quality-of-life score (SF36), and co-morbidities improvement.
The 10 patients had a median weight of 127 kg (range, 115-196 kg) and median body mass index of 47 kg/m(2) (range, 38-67 kg/m(2)). The operation was successful in all patients with a median operating time of 110 minutes (range, 75-240 minutes). The median hospital stay was 3 days (range, 3-4 days) and three of the patients required overnight observation in the intensive care unit because of severe sleep apnoea and asthma. The median follow-up period was 12 months (range, 1-18 months). The mean weight loss at 6, 12, and 18 months was 19.3, 22.4, and 25.9 kg, respectively. Mean percentage of excessive weight loss at 6, 12, and 18 months was 34.9%, 36.5%, and 40.5%, respectively. Unsatisfactory weight loss (<20 kg) occurred in three patients because of poor dietary compliance and non-follow-up. Surgery also considerably improved the patients' co-morbidities (hypertension, diabetes, and obstructive sleep apnoea) and the quality of life.
In the short term, laparoscopic adjustable gastric banding is certainly an effective procedure for morbid obesity, which results in a substantial weight loss and improvement of co-existing morbidities. Longer follow-up will show whether this weight loss is maintainable.
评估腹腔镜可调节胃束带术在中国肥胖患者队列中治疗病态肥胖的疗效。设计：队列研究。
香港大学教学医院。
2002年8月至2003年9月，10例患者（6例男性，4例女性）接受腹腔镜可调节胃束带术治疗病态肥胖，中位年龄34岁（范围23 - 48岁）。90%的病例存在多种并存疾病。在决定采用何种手术前，我们采用团队协作方式，让每位患者咨询营养师、内科医生、精神科医生（如有必要）及外科医生。
超重体重减轻情况、生活质量评分（SF36）及并存疾病改善情况。
10例患者中位体重127kg（范围115 - 196kg），中位体重指数47kg/m²（范围38 - 67kg/m²）。所有患者手术均成功，中位手术时间110分钟（范围75 - 240分钟）。中位住院时间3天（范围3 - 4天），3例患者因严重睡眠呼吸暂停和哮喘需在重症监护病房过夜观察。中位随访期12个月（范围1 - 18个月）。6、12和18个月时的平均体重减轻分别为19.3kg、22.4kg和25.9kg。6、12和18个月时超重体重减轻的平均百分比分别为34.9%、36.5%和40.5%。3例患者因饮食依从性差和未随访导致体重减轻未达理想效果（<20kg）。手术还显著改善了患者的并存疾病（高血压、糖尿病和阻塞性睡眠呼吸暂停）及生活质量。
短期内，腹腔镜可调节胃束带术对于病态肥胖肯定是一种有效的手术方法，可实现显著体重减轻并改善并存疾病。更长时间的随访将表明这种体重减轻是否可持续。
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