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非裔美国人和白人接受腹腔镜可调节胃束带术后的结局比较。

Comparison of outcomes after laparoscopic adjustable gastric banding in African-Americans and whites.

作者信息

Parikh Manish, Lo Helen, Chang Christopher, Collings Dinee, Fielding George, Ren Christine

机构信息

Program for Surgical Weight Loss, Department of Surgery, New York University School of Medicine, New York, New York 10016, USA.

出版信息

Surg Obes Relat Dis. 2006 Nov-Dec;2(6):607-10; discussion 610-2. doi: 10.1016/j.soard.2006.08.012. Epub 2006 Oct 3.

Abstract

BACKGROUND

Race may affect outcomes after bariatric surgery. This study compares outcomes in terms of weight loss and comorbidity resolution between African-Americans and whites after laparoscopic adjustable gastric banding (LAGB).

METHODS

Data from 959 patients undergoing LAGB between July 2001 and July 2004 were prospectively collected and entered into an electronic registry. Propensity score matching analysis was used to match whites to African-Americans on the basis of age, gender, and preoperative body mass index (BMI). Preoperative comorbidities (diabetes, hypertension, obstructive sleep apnea, hypercholesterolemia, and hypertriglyceridemia) were also compared. Operative time (OR), length of stay (LOS), comorbidity resolution, and percent excess weight loss (%EWL) at 1, 2, and 3 years were analyzed. All data were updated through May 2006.

RESULTS

A total of 65 white LAGB patients were matched to 58 African-American LAGB patients on the basis of age, gender, and preoperative BMI. The preoperative mean age and BMI were 37 +/- 19 years and 47 +/- 7 kg/m2, respectively. A total of 55% of the white group and 64% of the African-American group had one or more comorbidities (P = NS). Median OR time and LOS were similar in both groups: 50 minutes and 23 hours, respectively. The majority of patients in both groups had major improvement or resolution of one or more comorbidities (61% whites vs 77% African-Americans, P = NS). There was, however, a significant difference in %EWL between whites and African-Americans at each time interval (49% vs 39% at 1 year; 55% vs 44% at 2 years; 52% vs 41% at 3 years; P < .05 for all values.).

CONCLUSION

Despite the disparity in weight loss with the LAGB in African-Americans and whites, both patient populations experienced a similar improvement/resolution of obesity-related comorbidities.

摘要

背景

种族可能会影响减肥手术后的结果。本研究比较了非裔美国人和白人在接受腹腔镜可调节胃束带术(LAGB)后在体重减轻和合并症缓解方面的结果。

方法

前瞻性收集了2001年7月至2004年7月期间959例行LAGB手术患者的数据,并录入电子登记系统。采用倾向评分匹配分析,根据年龄、性别和术前体重指数(BMI)将白人患者与非裔美国患者进行匹配。还比较了术前合并症(糖尿病、高血压、阻塞性睡眠呼吸暂停、高胆固醇血症和高甘油三酯血症)。分析了手术时间(OR)、住院时间(LOS)、合并症缓解情况以及1年、2年和3年时的超重体重减轻百分比(%EWL)。所有数据更新至2006年5月。

结果

根据年龄、性别和术前BMI,共65例白人LAGB患者与58例非裔美国LAGB患者进行了匹配。术前平均年龄和BMI分别为37±19岁和47±7kg/m²。白人组55%、非裔美国组64%有一项或多项合并症(P=无显著性差异)。两组的中位OR时间和LOS相似,分别为50分钟和23小时。两组大多数患者的一种或多种合并症有显著改善或缓解(白人61%,非裔美国人77%,P=无显著性差异)。然而,在每个时间间隔,白人和非裔美国人的%EWL存在显著差异(1年时49%对39%;2年时55%对44%;3年时52%对41%;所有值P<0.05)。

结论

尽管非裔美国人和白人在接受LAGB后的体重减轻存在差异,但两组患者在肥胖相关合并症的改善/缓解方面相似。

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