Anwar Mohamed, Collins Jane, Kow Lilian, Toouli James
Department of General and Digestive Surgery, Flinders Medical Center and Adelaide Bariatric Center, South Australia, Australia.
Ann Surg. 2008 May;247(5):771-8. doi: 10.1097/SLA.0b013e31816bcd28.
To determine the long-term efficacy and safety of a low-pressure adjustable gastric band in the treatment for morbid obesity and to detect whether age, gender, or preoperative body mass index (BMI) has an impact on the outcome.
It is well known that low-pressure adjustable gastric bands such as the Swedish adjustable gastric bands (SAGB) lead to weight loss. However, very few long-term studies have been published and questions remain regarding long-term efficacy and safety, and whether any of the patient's demographic parameters including age, gender, or initial BMI impact the long-term outcome.
Six hundred consecutive patients who had a SAGB inserted between August 1996 and October 2005 were evaluated with regard to their initial BMI, age, and sex.
There were 488 females and 112 males, with mean age 45.3 +/- 9.1, mean BMI 42.9 +/- 7.2 kg/m2, and mean weight 119.6 +/- 23.9 kg. Overall morbidity was 25.7% (10.4% perioperative, whereas 15.3% on long term). The following data represents 2, 3, 5, and 7 years of follow-up respectively. Mean BMI decreased to 30.9, 30.5, 32.7, and 31.2 kg/m2, whereas mean percentage excess weight loss (%EWL) was 60.5%, 61.5%, 53.2%, and 61.2%. Patients with BMI (<40 kg/m2) lost 63.7%, 61.2%, 45.5%, and 66.1% of their excess weight, whereas patients with BMI (40-49.9 kg/m2) lost 60.1%, 61.3%, 59.4%, and 66.6%, patients with BMI (50-50.9 kg/m2) lost 57.5%, 67.5%, 49.3%, and 40.2%, and patients with BMI (>60 kg/m2) lost 42.2%, 46.3%, 38.7%, and 40.2%. Female patients %EWL were 62.2%, 62.1%, 55.1%, and 62.3%, whereas male %EWL were 54.1%, 59.1%, 42.1%, and 51.3%. Patients <40 years %EWL were 61.8%, 62.5%, 57.1%, and 86.2%, whereas >40 years %EWL were 60.1%, 61.2%, 52.4%, and 60.1%.
The SAGB is effective in achieving long-term sustainable weight loss with an acceptably low complication rate. Bands are effective regardless of patients' age and gender. Furthermore, preoperative BMI up to 60 kg/m2 does not influence the outcome.
确定低压可调式胃束带治疗病态肥胖的长期疗效和安全性，并检测年龄、性别或术前体重指数（BMI）是否对治疗结果有影响。
众所周知，诸如瑞典可调式胃束带（SAGB）之类的低压可调式胃束带可导致体重减轻。然而，很少有长期研究发表，关于长期疗效和安全性以及包括年龄、性别或初始BMI在内的任何患者人口统计学参数是否会影响长期治疗结果仍存在疑问。
对1996年8月至2005年10月期间连续600例接受SAGB植入的患者的初始BMI、年龄和性别进行评估。
有488名女性和112名男性，平均年龄45.3±9.1岁，平均BMI 42.9±7.2kg/m²，平均体重119.6±23.9kg。总体发病率为25.7%（围手术期为10.4%，长期为15.3%）。以下数据分别代表2年、3年、5年和7年的随访情况。平均BMI分别降至30.9、30.5、32.7和31.2kg/m²，而平均超重体重减轻百分比（%EWL）分别为60.5%、61.5%、53.2%和61.2%。BMI（<40kg/m²）的患者超重体重减轻了63.7%、61.2%、45.5%和66.1%，BMI（40 - 49.9kg/m²）的患者超重体重减轻了60.1%、61.3%、59.4%和66.6%，BMI（50 - 59.9kg/m²）的患者超重体重减轻了57.5%、67.5%、49.3%和40.2%，BMI（>60kg/m²）的患者超重体重减轻了42.2%、46.3%、38.7%和40.2%。女性患者的%EWL分别为62.2%、62.1%、55.1%和62.3%，而男性患者的%EWL分别为54.1%、59.1%、42.1%和51.3%。年龄<40岁的患者%EWL分别为61.8%、62.5%、57.1%和86.2%，而年龄>40岁的患者%EWL分别为60.1%、61.2%、52.4%和60.1%。
SAGB能有效实现长期可持续减重，并发症发生率可接受。无论患者年龄和性别，胃束带均有效。此外，术前BMI高达60kg/m²并不影响治疗结果。
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