Mognol Philippe, Chosidow Denis, Marmuse Jean-Pierre
Service de Chirurgie Générale A, Hôpital Bichat, Paris, France.
Obes Surg. 2005 Jan;15(1):76-81. doi: 10.1381/0960892052993486.
Controversy exists regarding the best surgical treatment for super-obesity (BMI >50 kg/m2). The two most common bariatric procedures performed worldwide are laparoscopic adjustable gastric banding (LAGB) and laparoscopic Roux-en-Y gastric bypass (LRYGBP). We undertook a retrospective single-center study to compare the safety and efficacy of these two operations in super-obese patients.
290 super-obese patients underwent laparoscopic bariatric surgery: 179 LAGB and 111 LRYGBP.
There were one death in both groups. The early complication rate was higher in the LAGB group (10% vs 2.8%, P<0.01). Late complication rate was higher in the LAGB group (26% vs 15.3%, P<0.05). Operating time and hospital stay were significantly higher in the LRYGBP group. LRYGBP had significantly better excess weight loss than LAGB (63% vs 41% at 1 year, and 73% vs 46% at 2 years), as well as lower BMI than LAGB (35 vs 41 at 18 months).
LRYGBP results in significantly greater weight loss than LAGB in super-obese patients, but is associated with a higher early complication rate.
对于超级肥胖（BMI>50kg/m²）的最佳手术治疗方法存在争议。全球范围内最常见的两种减肥手术是腹腔镜可调节胃束带术（LAGB）和腹腔镜Roux-en-Y胃旁路术（LRYGBP）。我们进行了一项回顾性单中心研究，以比较这两种手术在超级肥胖患者中的安全性和有效性。
290例超级肥胖患者接受了腹腔镜减肥手术：179例行LAGB，111例行LRYGBP。
两组均有1例死亡。LAGB组的早期并发症发生率更高（10%对2.8%，P<0.01）。LAGB组的晚期并发症发生率更高（26%对15.3%，P<0.05）。LRYGBP组的手术时间和住院时间明显更长。LRYGBP在超重减轻方面明显优于LAGB（1年时为63%对41%，2年时为73%对46%），且18个月时的BMI也低于LAGB（35对41）。
在超级肥胖患者中，LRYGBP导致的体重减轻明显大于LAGB，但早期并发症发生率较高。
