Gastro Obeso Center, São Paulo, Brazil.
Surg Obes Relat Dis. 2010 Jul-Aug;6(4):423-7. doi: 10.1016/j.soard.2009.09.016. Epub 2009 Oct 6.
One of the complications of laparoscopic adjustable gastric banding is intragastric erosion, leading to a revisional procedure to remove the band. Our aim was to present the procedure and results of endoscopic band removal in a 5-year multicenter experience from the Gastro Obeso Center and Universidade de São Paulo, São Paulo, and Universidade Federal de Pernambuco, Recife, Brazil.
From 2003 to 2008, 82 patients were diagnosed with band erosion. The clinical data concerning the endoscopic procedure were prospectively recorded and retrospectively reviewed.
The average preoperative body mass index was 43.2 kg/m(2) (range 34-50). At the diagnosis of intragastric erosion, the body mass index was 24-41 kg/m(2) (average 31.8). The erosion occurred an average of 16.3 months (range 6-36) postoperatively. The symptoms included pain in 25 (31%), port infection in 21 patients (27%), and weight regain in 20 (25%), and 12 patients (15%) were asymptomatic. Endoscopic removal was possible for 78 patients (95%). In 85% of patients, the band was removed in the first session, with an average duration of 55 minutes (range 25-150). Five cases of pneumoperitoneum occurred after the procedure. Of these, 3 were treated conservatively, 1 was treated by laparoscopy, and 1 was treated by abdominal puncture using the Veress needle.
Endoscopic removal of eroded laparoscopic adjustable gastric banding is safe and effective. It can be used as a first choice procedure in clinical practice.
腹腔镜可调节胃束带术的并发症之一是胃内侵蚀，导致需要进行翻修手术来移除束带。我们的目的是展示巴西圣保罗 Gastro Obeso 中心和 Universidade de São Paulo 以及 Pernambuco 联邦大学的 5 年多中心内镜下移除束带的经验和结果。
2003 年至 2008 年，82 例患者被诊断为束带侵蚀。前瞻性地记录了与内镜手术相关的临床数据，并进行了回顾性分析。
平均术前体重指数为 43.2kg/m²（范围 34-50）。在诊断为胃内侵蚀时，体重指数为 24-41kg/m²（平均 31.8）。侵蚀发生在术后平均 16.3 个月（范围 6-36）。症状包括疼痛 25 例（31%）、端口感染 21 例（27%）、体重反弹 20 例（25%）和 12 例（15%）无症状。78 例患者（95%）可行内镜下移除。在 85%的患者中，束带在第一次手术中被移除，平均时间为 55 分钟（范围 25-150）。手术后发生了 5 例气腹。其中 3 例保守治疗，1 例腹腔镜治疗，1 例使用 Veress 针经腹部穿刺治疗。
内镜下移除侵蚀性腹腔镜可调节胃束带是安全有效的。它可以作为临床实践中的首选方法。
