Taylor Craig John, Layani Laurent
Obesity Surgery Centre, John Flynn Hospital, Queensland, Australia.
Obes Surg. 2006 Dec;16(12):1579-83. doi: 10.1381/096089206779319310.
Laparoscopic adjustable gastric banding (LAGB) is an effective treatment for morbid obesity in younger patients, leading to improvements in related co-morbidities and quality of life. Currently, little is known how these improvements apply to older patients.
A prospective review was conducted of patients > or =60 years old undergoing LAGB. Weight loss, complications, changes in Short Form-36 (SF-36) scores, and a comprehensive post-operative co-morbidity, medication and quality of life questionnaire were used to assess performance.
40 patients with mean age 65.8 years (range 60-72) and preoperative mean BMI of 42.2 kg/m(2) (range 33-54) underwent LAGB from February 2000 to September 2005. Mean excess weight lost at 2 years was 54%. 3 complications (7.5%) occurred (1 slippage and 2 access-port infections). There were no perforations, erosions or deaths. After a mean postoperative interval of 27 months, SF-36 scores improved significantly in 4 of 8 components and exceeded age-matched population controls in 3 components. Co-morbidity improvement was reported in 80% of patients with diabetes, 79% with dyslipidemia, 75% with obstructive sleep apnea, 72% with heartburn, 69% with hypertension, 60% with musculoskeletal pain, and 56% with anxiety/depression. Medication requirements reduced or ceased in 66% who required musculoskeletal analgesics, 43% of diabetics, 33% using bronchodilators, and 29% with hypertension. Sleep improved in 48%, self-esteem increased in 70%, and 72% had a better outlook on life. 82% were happy that they had undergone LAGB, and 91% would recommend LAGB to other older people.
LAGB offers safe and effective weight loss, and improvement in co-morbidities and in quality of life in morbidly obese patients aged > or =60 years.
腹腔镜可调节胃束带术（LAGB）是治疗年轻病态肥胖患者的有效方法，可改善相关合并症及生活质量。目前，对于这些改善如何适用于老年患者知之甚少。
对年龄≥60岁接受LAGB手术的患者进行前瞻性评估。采用体重减轻情况、并发症、简短健康调查问卷（SF-36）评分变化，以及一份全面的术后合并症、用药及生活质量问卷来评估手术效果。
2000年2月至2005年9月，40例平均年龄65.8岁（范围60 - 72岁）、术前平均体重指数（BMI）为42.2 kg/m²（范围33 - 54）的患者接受了LAGB手术。2年时平均超重减轻了54%。发生了3例并发症（7.5%）（1例胃束带滑脱和2例接入端口感染）。无穿孔、糜烂或死亡病例。术后平均间隔27个月后，SF-36评分在8个分量表中的4个有显著改善，3个分量表超过了年龄匹配的人群对照组。据报告，80%的糖尿病患者、79%的血脂异常患者、75%的阻塞性睡眠呼吸暂停患者、72%的烧心患者、69%的高血压患者、60%的肌肉骨骼疼痛患者以及56%的焦虑/抑郁患者的合并症得到改善。66%需要肌肉骨骼镇痛药物的患者、43%的糖尿病患者、33%使用支气管扩张剂的患者以及29%的高血压患者的用药需求减少或停止。48%的患者睡眠改善，70%的患者自尊增强，72%的患者对生活的看法更积极。82%的患者对接受LAGB手术感到满意，91%的患者会向其他老年患者推荐LAGB手术。
LAGB为年龄≥60岁的病态肥胖患者提供了安全有效的体重减轻效果，并改善了合并症及生活质量。
