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腹腔镜胃旁路手术后非裔美国人与白种人一样成功吗?

Are African-Americans as successful as Caucasians after laparoscopic gastric bypass?

作者信息

Madan Atul K, Whitfield John D, Fain John N, Beech Bettina M, Ternovits Craig A, Menachery Suraj, Tichansky David S

机构信息

Section of Minimally Invasive Surgery, Department of Surgery, University of Tennessee Health Science Center, 956 Court Ave., Room G210, Memphis, TN 38163, USA.

出版信息

Obes Surg. 2007 Apr;17(4):460-4. doi: 10.1007/s11695-007-9083-5.

Abstract

BACKGROUND

Laparoscopic Roux-en-Y gastric bypass (LRYGBP) has been demonstrated to provide weight loss comparable to open gastric bypass. It has been suggested that African-Americans (AA) are not as successful as Caucasians (CA) after bariatric surgery. Our hypothesis was that AAs are just as successful as CA after LRYGBP in terms of weight loss and comorbidity improvement.

METHODS

A retrospective chart review was performed on all AA and CA patients who underwent LRYGBP for a 6-month period. Success after LRYGBP [defined as (1) 25% loss of preoperative weight, (2) 50% excess weight loss (EWL), or (3) weight loss to within 50% ideal weight] was compared by ethnicity.

RESULTS

102 patients were included in this study. 97 patients (30 AA patients and 67 CA patients) had at least 1-year follow-up data available. Preoperative data did not differ between both groups. There was a statistically significant difference in %EWL between AA and CA (66% vs 74%; P<0.05). However, there was no ethnic difference in the percentage of patients with successful weight loss (as defined by any of the above 3 criteria). Furthermore, there was no statistical difference between the percentages of AA and CA patients who had improved or resolved diabetes and hypertension.

CONCLUSIONS

LRYGBP offers good weight loss in all patients. While there may be greater %EWL in CA patients, no ethnic difference in successful weight loss exists. More importantly, co-morbidities improve or resolve equally between AA and CA patients. LRYGBP should be considered successful in AA patients.

摘要

背景

腹腔镜Roux-en-Y胃旁路术(LRYGBP)已被证明能实现与开腹胃旁路术相当的体重减轻效果。有人提出,非裔美国人(AA)在减肥手术后不如白种人(CA)成功。我们的假设是,在LRYGBP术后,非裔美国人在体重减轻和合并症改善方面与白种人一样成功。

方法

对所有在6个月期间接受LRYGBP手术的非裔美国人和白种人患者进行回顾性病历审查。根据种族比较LRYGBP术后的成功情况[定义为:(1)术前体重减轻25%;(2)多余体重减轻(EWL)50%;或(3)体重减轻至理想体重的50%以内]。

结果

本研究纳入了102例患者。97例患者(30例非裔美国患者和67例白种患者)有至少1年的随访数据。两组术前数据无差异。非裔美国人和白种人之间的EWL%有统计学显著差异(66%对74%;P<0.05)。然而,在体重减轻成功的患者百分比方面(根据上述3条标准中的任何一条定义)不存在种族差异。此外,非裔美国人和白种人患者中糖尿病和高血压得到改善或缓解的百分比之间无统计学差异。

结论

LRYGBP能使所有患者实现良好的体重减轻。虽然白种患者的EWL%可能更高,但在体重减轻成功方面不存在种族差异。更重要的是,非裔美国人和白种人患者之间的合并症改善或缓解情况相同。LRYGBP在非裔美国患者中应被视为成功。

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