Folope V, Hellot M-F, Kuhn J-M, Ténière P, Scotté M, Déchelotte P
Department of Endocrinology, IFR23-University Hospital of Rouen, Rouen, France.
Eur J Clin Nutr. 2008 Aug;62(8):1022-30. doi: 10.1038/sj.ejcn.1602808. Epub 2007 Aug 1.
Long term evaluation of bariatric surgery must include quality of life measurement.
Quality of life (QoL) was evaluated using the original Moorehead-Ardelt questionnaire for 200 patients operated for massive obesity in a single centre between 1994 and 2003. QoL and physical data were obtained by retrospective mail questionnaire. Surgical procedures were vertical-banded gastroplasty according to Mason (VBGM) and adjustable gastric banding (AGB) in 61 and 39% of patients, respectively. The aim of the study was to assess the nutritional outcome and QoL according to the procedure.
Overall, the body mass index (BMI) decreased from 50+/-8 kg/m(2) before surgery to 35.2+/-7.5 kg/m(2) at the time of the questionnaire. The percentage of weight loss was 28.8+/-12.2%. In the group treated with VBGM, the mean initial weight (P=0.003) and the percentage of weight loss (P<0.001) were significantly higher, and the QoL was better (P=0.003) than in the group treated with AGB. On the basis of the time spent since surgery, a regular weight loss was observed during the first 5 years, whereas weight subsequently increased over the five following years. Similarly, the total QoL score gradually improved during the first 5 years and worsened thereafter. However, it remained better than before surgery. A linear regression analysis showed a positive correlation between the percentage of weight loss and the QoL score (P<0.001).
This study suggests that the bariatric surgery, particularly the VBGM technique, improved the QoL of obese patients, at least in the first 5 years following surgery.
对减肥手术的长期评估必须包括生活质量的测量。
使用最初的穆尔黑德 - 阿德尔特问卷对200例于1994年至2003年在单一中心接受重度肥胖手术的患者进行生活质量评估。通过回顾性邮件问卷获取生活质量和身体数据。手术方式分别为根据梅森术式的垂直束带胃成形术(VBGM)和可调节胃束带术(AGB),分别占患者的61%和39%。本研究的目的是根据手术方式评估营养结局和生活质量。
总体而言,体重指数(BMI)从手术前的50±8kg/m²降至问卷调查时的35.2±7.5kg/m²。体重减轻百分比为28.8±12.2%。在接受VBGM治疗的组中,平均初始体重(P = 0.003)和体重减轻百分比(P < 0.001)显著更高,且生活质量比接受AGB治疗的组更好(P = 0.003)。根据手术后的时间,在前5年观察到体重有规律地减轻,而在随后的5年中体重增加。同样,总生活质量评分在前5年逐渐改善,此后恶化。然而,仍优于手术前。线性回归分析显示体重减轻百分比与生活质量评分之间存在正相关(P < 0.001)。
本研究表明减肥手术,特别是VBGM技术,至少在术后的前5年改善了肥胖患者的生活质量。