Ciovica Ruxandra, Takata Mark, Vittinghoff Eric, Lin Feng, Posselt Andrew M, Rabl Charlotte, Stein Hubert J, Campos Guilherme M
Bariatric Surgery Program, Department of Surgery, University of California San Francisco, 521 Parnassus Avenue, C-341, San Francisco, CA, 94143-0790, USA.
Obes Surg. 2008 Jan;18(1):5-10. doi: 10.1007/s11695-007-9312-y. Epub 2007 Dec 7.
Extending the length of the Roux limb (RL) in gastric bypass (GBP) may improve weight loss in super obese patients (body mass index [BMI] > 50 kg/m(2)), but no consensus exists about the optimal length of the RL. We sought to determine the impact of RL length on weight loss in super obese patients 1 year after GBP.
One-year weight loss outcomes were analyzed in all super obese patients who underwent consecutive and primary laparoscopic or open GBP between January 2003 and June 2006. Patients were divided into two groups according to RL length (100 vs. 150 cm). The RL length was at the discretion of the attending surgeon. Baseline and follow-up data were collected prospectively. Multiple linear regression was used to adjust for potential confounders in the weight loss outcomes.
Twelve-month follow-up data were available in 137 (85%) of 161 patients with a BMI >or= 50 who underwent GBP during the study period. An RL of 100 or 150 cm was used in 102 (74.5%) and 35 patients (25.5%), respectively. In multivariate analysis, patients with the 150-cm RL lost more weight (68.5 vs. 55.3 kg, p < 0.01), had a greater change in BMI (25 vs. 21 kg/m(2), p = 0.01), and had greater excess weight loss (64 vs. 53%, p < 0.01).
A 150-cm RL provides better weight loss outcomes in super obese patients at 1-year follow-up.
在胃旁路手术（GBP）中延长 Roux 袢（RL）的长度可能会改善超级肥胖患者（体重指数[BMI]＞50kg/m²）的体重减轻情况，但关于 RL 的最佳长度尚无共识。我们试图确定 GBP 术后 1 年时 RL 长度对超级肥胖患者体重减轻的影响。
分析了 2003 年 1 月至 2006 年 6 月期间连续接受初次腹腔镜或开放 GBP 的所有超级肥胖患者的 1 年体重减轻结果。根据 RL 长度（100 与 150cm）将患者分为两组。RL 长度由主刀医生决定。前瞻性收集基线和随访数据。采用多元线性回归对体重减轻结果中的潜在混杂因素进行校正。
在研究期间接受 GBP 的 161 例 BMI≥50 的患者中，137 例（85%）有 12 个月的随访数据。分别有 102 例（74.5%）和 35 例（25.5%）患者使用了 100cm 或 150cm 的 RL。在多变量分析中，RL 为 150cm 的患者体重减轻更多（68.5 对 55.3kg，p＜0.01），BMI 变化更大（25 对 21kg/m²，p = 0.01），且超重减轻更多（64 对 53%，p＜0.01）。
在 1 年随访中，150cm 的 RL 能为超级肥胖患者提供更好的体重减轻效果。
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