Watkins Brad M, Montgomery Kevin F, Ahroni Jessie H
Northwest Weight Loss Surgery, Kirkland, WA 98034, USA.
Obes Surg. 2005 Jan;15(1):82-7. doi: 10.1381/0960892052993602.
Early experience with 400 consecutive patients who underwent laparoscopic adjustable gastric banding (LAGB) is reported.
From Nov 2002 to Aug 2004, prospective data were collected on 400 consecutive LAGB patients and evaluated retrospectively.
There were 354 (88.5%) females and 46 males (11.5%), with mean age 43.6 years and mean BMI 46.2 kg/m2. For outpatients (freestanding ambulatory surgery center), mean OR time was 55.4 min in 208 patients (52%), compared to mean inpatient OR time of 70.5 min in 192 patients. Inpatients had a higher BMI (48.2 +/- 9.3 SD) than outpatients (43.9 +/- 5.7 SD) (P<0.0001). Complications occurred in 35 patients (8.8%). These consisted of 9 slipped bands (2.3%) that were surgically repositioned, 6 port problems (1.5%) that were successfully repaired, 17 patients with temporary stoma occlusion (4.3%) that spontaneously resolved, and 2 bowel perforations (0.5%) that required surgical repair and band removal. One patient died of pneumonia 2 weeks after an uneventful procedure. Average 1-year percent excess weight loss (%EWL) in 138 patients was 48.2%. Patients who had < or =50 kg initial excess weight (n=37, 27%) had a significantly higher %EWL (55.2%) at 1 year than patients who had >50 kg initial excess weight (P=0.0011).
LAGB has been safe and effective thus far for the surgical treatment of morbid obesity, and can be performed as an outpatient in select patients.
报告了连续400例接受腹腔镜可调节胃束带术（LAGB）患者的早期经验。
从2002年11月至2004年8月，前瞻性收集连续400例LAGB患者的数据并进行回顾性评估。
有354名女性（88.5%）和46名男性（11.5%），平均年龄43.6岁，平均体重指数（BMI）为46.2kg/m²。对于门诊患者（独立门诊手术中心），208例患者（52%）的平均手术时间为55.4分钟，相比之下，192例住院患者的平均手术时间为70.5分钟。住院患者的BMI（48.2±9.3标准差）高于门诊患者（43.9±5.7标准差）（P<0.0001）。35例患者（8.8%）出现并发症。其中包括9例束带滑脱（2.3%），通过手术重新定位；6例端口问题（1.5%），成功修复；17例患者出现临时造口闭塞（4.3%），自行缓解；2例肠穿孔（0.5%），需要手术修复并移除束带。1例患者在手术顺利进行2周后死于肺炎。138例患者的平均1年超重体重减轻百分比（%EWL）为48.2%。初始超重体重≤50kg的患者（n=37，27%）在1年时的%EWL（55.2%）显著高于初始超重体重>50kg的患者（P=0.0011）。
迄今为止，LAGB对于病态肥胖的外科治疗一直是安全有效的，并且可以在特定患者中作为门诊手术进行。
