John Flynn Private Hospital, Tugun, QLD, Australia.
Obes Surg. 2011 May;21(5):604-8. doi: 10.1007/s11695-009-9931-6. Epub 2009 Aug 14.
In some bariatric patients with predominantly intra-abdominal fat a shallow fat layer separates the gastric band access port from the skin. We hypothesise that subfascial port placement in these patients reduces skin erosions and port infections and improves cosmesis as weight loss occurs.
This study aims to compare port complications, cosmetic outcome and ease of band adjustment with access ports in front of or behind the rectus muscle.
We retrospectively compared complications and cosmetic outcomes of patients with subfascial ports to a control group matched for gender, BMI and age. Each subject completed a questionnaire utilising a 1 to 10 scale for nine parameters related to comfort and cosmesis and two parameters related to discomfort during adjustments.
Sixty-eight patients with subfascial ports were identified and the overall response rate was 84%. The groups were well matched for gender (m:f ratio 1.8:1 vs. 1.7:1, p = 1.000), age (51.0 vs. 49.6 years, p = 0.528) and BMI (39.8 vs. 40.3 kg/m², p = 0.585). There was no difference in port infection rates (0/68 vs. 1/68, p = 1.000) but the subfascial group had more hernias (3/68 vs. 0/68, p = 0.244). Subfascial patients experienced more pain during adjustments (score 4.3 vs. 2.6, p = 0.047) but a combined analysis of cosmesis showed a slight positive trend (1.58 vs. 1.76, p = 0.379).
Both port locations are well tolerated. Subfascial placement is associated with more pain during adjustments but there is no difference in port infection or skin erosion rates.
在一些主要有腹腔内脂肪的肥胖患者中，浅层脂肪层将胃带接入端口与皮肤隔开。我们假设，在这些患者中，皮下放置端口可以减少皮肤侵蚀和端口感染，并随着体重减轻改善美容效果。
本研究旨在比较皮下和肌前胃带接入端口在并发症、美容效果和带调整的便利性方面的差异。
我们回顾性地比较了皮下和肌前端口的并发症和美容效果，并将其与性别、BMI 和年龄相匹配的对照组进行比较。每位患者都完成了一份问卷，其中使用 1 到 10 分的量表对与舒适度和美容效果相关的九个参数以及与调整时不适相关的两个参数进行了评估。
共确定了 68 例皮下端口患者，总体应答率为 84%。两组在性别（男性：女性比例 1.8:1 与 1.7:1，p=1.000）、年龄（51.0 岁与 49.6 岁，p=0.528）和 BMI（39.8 千克/平方米与 40.3 千克/平方米，p=0.585）方面匹配良好。两组的端口感染率没有差异（0/68 与 1/68，p=1.000），但皮下组的疝发生率更高（3/68 与 0/68，p=0.244）。皮下组患者在调整时疼痛更明显（评分 4.3 与 2.6，p=0.047），但综合美容效果分析显示略有积极趋势（1.58 与 1.76，p=0.379）。
两种端口位置均能很好地耐受。皮下放置与调整时疼痛增加有关，但在端口感染或皮肤侵蚀率方面没有差异。
