Hoeller Elisabeth, Aigner Franz, Margreiter Raimund, Weiss Helmut
Medical University Innsbruck, Department of General and Transplant Surgery, Innsbruck, Austria.
Obes Surg. 2006 Sep;16(9):1160-5. doi: 10.1381/096089206778392301.
Gastric pacing has gained popularity as an effective and safe minimally invasive procedure to treat morbid obesity. This study evaluates the outcome of gastric pacing as a bariatric re-do procedure in patients who developed failure after adjustable gastric banding (AGB) due to band migration.
8 patients were enrolled in this analysis. After implantation of an AGB, they had developed band failure due to band migration. The implantable gastric stimulator (IGS) was implanted laparoscopically as a second-line operation after gastroscopic removal of the band.
Median time (range) from AGB complication to implantation of the IGS was 42 (10.3-50.3) months. During that time, all 8 patients had regained significant weight. All IGS devices could be implanted laparoscopically, without intra- or perioperative complications. The minimal body weight following IGS implantation was reached after 5 (0-12) months. The median observation time was 23 (11.3-27.5) months. 1 year after IGS implantation (n=7), median weight was 116 (98-165) kg, equivalent to a median BMI of 41.1 (36.055.8) kg/m(2), which is not statistically different to preoperative values and therefore prompted us to stop our ongoing trial. In all but 2 patients, the IGS device was explanted. During the same procedure, patients underwent a gastric sleeve resection (n=4) or a Roux-en-Y gastric bypass (n=2).
The implantation of an IGS was an ineffective second-line operation after AGB migration.
胃起搏作为一种治疗病态肥胖的有效且安全的微创手术已受到广泛关注。本研究评估了胃起搏作为一种减肥二次手术在因可调节胃束带（AGB）移位而失败的患者中的疗效。
8例患者纳入本分析。在植入AGB后，他们因束带移位出现了束带失败。在胃镜下取出束带后，通过腹腔镜植入可植入式胃刺激器（IGS）作为二线手术。
从AGB并发症到植入IGS的中位时间（范围）为42（10.3 - 50.3）个月。在此期间，所有8例患者体重均显著回升。所有IGS装置均可通过腹腔镜植入，无术中或围手术期并发症。IGS植入后5（0 - 12）个月达到最低体重。中位观察时间为23（11.3 - 27.5）个月。IGS植入1年后（n = 7），中位体重为116（98 - 165）kg，相当于中位BMI为41.1（36.0 - 55.8）kg/m²，与术前值无统计学差异，因此促使我们停止正在进行的试验。除2例患者外，所有患者的IGS装置均被取出。在同一手术过程中，患者接受了胃袖状切除术（n = 4）或Roux - en - Y胃旁路术（n = 2）。
AGB移位后植入IGS作为二线手术无效。
