Novinscak T, Franjic B D, Glavan E, Bekavac-Beslin M
Division of General Surgery, General Hospital Cakovec, Cakovec, Croatia.
JSLS. 2006 Oct-Dec;10(4):421-5.
Morbid obesity is a growing medical problem that has become of epidemic proportions. Various dietary and pharmaceutical approaches do not obtain acceptable long-term results. Surgery, however, especially gastric restriction, represents a viable therapeutic solution. Individuals with a body mass index (BMI) >40 kg/m2 or >35 kg/m2 with at least one severe comorbidity are considered morbidly obese and generally qualify for weightloss surgery. Laparoscopic adjustable gastric banding (LAGB) is currently the most commonly performed procedure, because it is minimally invasive, does not cause metabolic complications, is completely reversible, and is adjustable. In Croatia, the first LAGB was performed in May 2004 at Clinical Hospital "Sestre Milosrdnice." The aim of this report is to illustrate a newly performed surgical treatment and its results for morbid obesity in Croatia.
Within a 12-month period, the adjustable gastric band was implanted in 15 morbidly obese patients (female, 8; male, 7; mean age, 46.67 years; range, 26-59 years). The so-called "pars flaccida" technique was used.
One operation required conversion to laparotomy due to a gastric lesion, and 1 laparoscopy operation was terminated due to massive postoperative adhesions. The average duration of surgery was 90+/-30 minutes. Mean length of stay was 4.9 days (range, 3-9). An average BMI at the time of surgery was 52.21 kg/m2 (range, 45.29 to 61.59; mean body weight was 155.58 kg (range, 127 to 204). Throughout 1-, 3-, 6-, 9-, and 12-month follow-ups, an average of 18.71%, 25.06%, 34.37%, 41.23%, and 47.32% of excessive weight loss (EWL) was observed. Good tolerance and a low complication rate were noted.
LAGB resulted in good early results and a low complication rate. LAGB appears to be a quality surgical procedure for the management of morbid obesity.
病态肥胖是一个日益严重的医学问题，已呈流行趋势。各种饮食和药物治疗方法都未能取得可接受的长期效果。然而，手术，尤其是胃限制手术，是一种可行的治疗方案。体重指数（BMI）>40 kg/m²或>35 kg/m²且至少有一种严重合并症的个体被视为病态肥胖，通常符合减肥手术的条件。腹腔镜可调节胃束带术（LAGB）是目前最常用的手术，因为它微创、不引起代谢并发症、完全可逆且可调节。在克罗地亚，首例LAGB于2004年5月在“斯雷斯特·米洛斯拉夫尼察”临床医院进行。本报告的目的是阐述在克罗地亚新开展的针对病态肥胖的手术治疗及其结果。
在12个月期间，为15例病态肥胖患者（女性8例，男性7例；平均年龄46.67岁，范围26 - 59岁）植入可调节胃束带。采用所谓的“松弛部”技术。
1例手术因胃部病变需转为开腹手术，1例腹腔镜手术因术后大量粘连而终止。手术平均时长为90±30分钟。平均住院时间为4.9天（范围3 - 9天）。手术时平均BMI为52.21 kg/m²（范围45.29至61.59；平均体重为155.58 kg（范围127至204）。在1个月、3个月、6个月、9个月和12个月的随访中，平均观察到超重减轻（EWL）分别为18.71%、25.06%、34.37%、41.23%和47.32%。观察到耐受性良好且并发症发生率低。
LAGB取得了良好的早期效果且并发症发生率低。LAGB似乎是治疗病态肥胖的一种优质手术方法。
