Balduyck B, Vansteenkiste S, Ruppert M, Balliu L, Vaneerdeweg W, Hubens G
Department of abdominal surgery, University Hospital of Antwerp, Belgium.
Acta Chir Belg. 2005 Apr;105(2):161-7.
To compare gastric banding (GB) and vertical banded gastroplasty (VBG) with respect to the evolution of pyrosis and patient satisfaction.
Although weight loss is the most immediate end-point in the evaluation of surgical treatment of obesity, the demonstration of changes in long-term patient satisfaction and in co-morbidity, like reflux, is an essential outcome measure.
Retrospective study of 243 morbidly obese patients. All patients received a questionnaire regarding the evolution of pyrosis and their satisfaction after surgery. The evolution of pyrosis was compared between 2 patient groups who had different oesophagitis stages. Group A had oesophagitis I, or no oesophagitis, and group B had oesophagitis II, III or IV.
In group A of the GB group 57.8% had no complaints, 11.1% had improvement and 22.2% had aggravation of the pyrosis. In group B of the GB group 50.0% had improvement. In group A of the VBG group 51.4% had no complaints, 11.1% improvement and 23.6% aggravation of the pyrosis. In group B of the VBG group 16.7% had no complaints, 66.6% had improvement and 16.7% had aggravation of the pyrosis complaints. Statistically there is no significant difference between GB and VBG. The experience after GB is good with 67.9%, mediocre with 25.0% and bad with 7.1% of the patients ; 60.7% is pleased with the weight loss. The experience after VBG is good with 47.4%, mediocre with 29.5% and bad with 23.1% of the patients. 52.6% is satisfied with the weight loss.
VBG and GB have a similar effect on pyrosis. From our point of view it has been evidenced that the presence or absence of pyrosis before the operation is a possible predictor of the evolution afterwards. Long-term patient satisfaction is the same after GB and VBG. Other factors influence the satisfaction.
比较胃束带术(GB)和垂直束带胃成形术(VBG)在烧心症状演变及患者满意度方面的情况。
尽管体重减轻是肥胖症手术治疗评估中最直接的终点,但证明患者长期满意度的变化以及诸如反流等合并症的变化是一项重要的结果指标。
对243例病态肥胖患者进行回顾性研究。所有患者均收到一份关于烧心症状演变及术后满意度的问卷。比较了处于不同食管炎阶段的两组患者烧心症状的演变情况。A组为Ⅰ级食管炎或无食管炎患者,B组为Ⅱ级、Ⅲ级或Ⅳ级食管炎患者。
GB组A组中,57.8%的患者无不适,11.1%的患者症状改善,22.2%的患者烧心症状加重。GB组B组中,50.0%的患者症状改善。VBG组A组中,51.4%的患者无不适,11.1%的患者症状改善,23.6%的患者烧心症状加重。VBG组B组中,16.7%的患者无不适,66.6%的患者症状改善,16.7%的患者烧心症状加重。统计学上,GB和VBG之间无显著差异。GB术后患者体验良好的占67.9%,中等的占25.0%,差的占7.1%;60.7%的患者对体重减轻感到满意。VBG术后患者体验良好的占47.4%,中等的占29.5%,差的占23.1%。52.6%的患者对体重减轻感到满意。
VBG和GB对烧心症状的影响相似。从我们的观点来看,已证明术前是否存在烧心症状可能是术后症状演变的一个预测指标。GB和VBG术后患者的长期满意度相同。其他因素影响满意度。