Toouli Jim, Kow Lilian, Collins Jane, Schloithe Ann, Oppermann Chris
Adelaide Bariatric Center and Flinders University, Adelaide, South Australia, Australia.
Surg Obes Relat Dis. 2008 May-Jun;4(3 Suppl):S31-8. doi: 10.1016/j.soard.2008.04.005.
Obesity is an increasingly common condition with serious associated morbidity and decreased life expectancy. Laparoscopic adjustable gastric banding (LAGB) has demonstrated its safety and efficacy as a surgical therapy for morbid obesity over the short term. The current study sought to determine the long-term safety and efficacy of a low-pressure LAGB.
Between August 1996 and July 2007, 1,000 consecutive patients underwent LAGB implantation with the Swedish Adjustable Gastric Band (SAGB). This series was retrospectively reviewed with regard to weight loss and morbidity. Patients served as their own controls.
Preoperatively, there were 808 women (81.0%) and 192 men (19.0%) with a mean age of 46 +/- 11 years (range 13-81 yrs) and mean body mass index (BMI) of 42.0 +/- 7.0 kg/m2 (range 27-82 kg/m2). At 1-, 3-, 6-, and 8-year follow-up, mean percent excess weight loss was 41% (n = 600), 56% (n = 367), 51% (n = 114), and 52% (n = 43), respectively. At the same time points, BMI decreased, from 42.0 to 31.0, 32.5, and 30.5 kg/m2, respectively. Complications occurred in 197 patients. There were 2 operative complications (i.e., stomach perforation and vascular injury) and 25 conversions (2.4%) to open surgery. Major and minor wound infection in the perioperative period occurred in 47 (4.7%) and 43 (4.3%) patients, respectively. There was 1 death from a myocardial infarct 1 week after surgery. Long term, there were 30 (3.0%) band slippages, 31 (3.1%) erosions, 67 (6.7%) port problems, and 12 (1.2%) incisional hernias.
LAGB with the SAGB is effective in achieving a mean sustainable weight loss of >50% at 8 years after surgery, with an acceptably low morbidity.
肥胖是一种日益常见的疾病，伴有严重的相关发病率且预期寿命缩短。腹腔镜可调节胃束带术（LAGB）已在短期内证明其作为治疗病态肥胖的手术疗法的安全性和有效性。本研究旨在确定低压LAGB的长期安全性和有效性。
1996年8月至2007年7月期间，1000例连续患者接受了瑞典可调节胃束带（SAGB）植入术。对该系列患者的体重减轻情况和发病率进行回顾性分析。患者以自身作为对照。
术前，有808名女性（81.0%）和192名男性（19.0%），平均年龄为46±11岁（范围13 - 81岁），平均体重指数（BMI）为42.0±7.0kg/m²（范围27 - 82kg/m²）。在1年、3年、6年和8年的随访中，平均超重减轻百分比分别为41%（n = 600）、56%（n = 367）、51%（n = 114）和52%（n = 43）。在相同时间点，BMI分别从42.0降至31.0、32.5和30.5kg/m²。197例患者出现并发症。有2例手术并发症（即胃穿孔和血管损伤）以及25例（2.4%）转为开放手术。围手术期分别有47例（4.7%）和43例（4.3%）患者发生了严重和轻微的伤口感染。术后1周有1例因心肌梗死死亡。长期来看，有30例（3.0%）束带滑脱、31例（3.1%）侵蚀、67例（6.7%）端口问题以及12例（1.2%）切口疝。
使用SAGB的LAGB在术后8年可有效实现平均可持续体重减轻>50%，发病率低至可接受水平。
