Fielding George A, Duncombe Jennifer E
The Wesley Hospital, Brisbane, Australia.
Obes Surg. 2005 May;15(5):634-40. doi: 10.1381/0960892053923879.
Concerns still exist about the long-term effectiveness and rate of retention of the laparoscopic adjustable gastric band (LAGB). Furthermore, esophageal dilatation has been suggested as a long-term complication for LAGB. We therefore sought to objectively analyze our follow-up results in patients with LAGB performed in 1998 by perigastric technique and 2000 by pars flaccida technique. We also offered patients for 1998 a barium esophagram to assess dilatation.
Data on all 2,300 LAGBs performed since 1996 have been prospectively collected in LapBase. This data was accessed for 1998 and 2000, for follow-up complication, band removal, weight loss and comorbidity reduction. Patients were offered barium esophagrams.
123 patients (mean weight 127 kg, mean BMI 44.5 kg/m2) had LAGB in 1998, and 162 patients (mean weight 123 kg, mean BMI 44) had LAGB in 2000. Follow-up was a mean 67 months in 88% for 1998 and 94% at 34 months for 2000. Mean %EWL for 1998 was 51.2% with mean BMI 31.9. Slippage occurred in 9.5% in 1998 compared to 4.3% in 2000 (P<0.01). 20 of 23 diabetics are off all treatment. 1 of 34 patients had esophageal dilatation on barium esophagram, which resolved on band deflation.
LAGB is a safe and effective at midterm follow-up. Less slippage occurred after the pars flaccida technique. No evidence of permanent esophageal dilatation was found on barium studies.
对于腹腔镜可调节胃束带术（LAGB）的长期有效性和保留率仍存在担忧。此外，食管扩张被认为是LAGB的一种长期并发症。因此，我们试图客观分析1998年采用胃周技术和2000年采用松弛部技术进行LAGB手术患者的随访结果。我们还为1998年手术的患者提供了钡餐食管造影以评估食管扩张情况。
自1996年以来实施的所有2300例LAGB手术的数据均已前瞻性收集到LapBase中。调取了1998年和2000年的数据，以了解随访并发症、束带移除、体重减轻和合并症减少情况。为患者提供了钡餐食管造影检查。
1998年有123例患者（平均体重127千克，平均体重指数44.5千克/平方米）接受了LAGB手术，2000年有162例患者（平均体重123千克，平均体重指数44）接受了LAGB手术。1998年患者的平均随访时间为67个月（88%），2000年患者在34个月时的随访率为94%。1998年平均%EWL为51.2%，平均体重指数为31.9。1998年束带滑脱发生率为9.5%，2000年为4.3%（P<0.01）。23例糖尿病患者中有20例停止了所有治疗。34例患者中有1例在钡餐食管造影时出现食管扩张，在束带放气后缓解。
中期随访显示LAGB是安全有效的。采用松弛部技术后束带滑脱较少。钡餐研究未发现永久性食管扩张的证据。
