Bariatric and Metabolic Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
Surg Obes Relat Dis. 2010 Jul-Aug;6(4):356-60. doi: 10.1016/j.soard.2009.11.021. Epub 2009 Dec 23.
The effect of group education classes before a Lap-Band procedure has not been well defined. We hypothesized that in a Medicaid population, the completion of a standardized 12-week multidisciplinary preoperative program (SMPP) would significantly improve the preoperative and early postoperative weight loss. All procedures were performed at a University-affiliated community hospital from 2006 to 2007.
A prospectively collected database of 292 patients who underwent Lap-Band placement was retrospectively reviewed. All patients in the study cohort were encouraged to participate in the SMPP, which included medical, psychological, and nutritional interventions. The patients were divided into 2 groups according to their participation in the SMPP program: SMPP compliant and non-SMPP compliant. The postoperative weight loss of these 2 groups was then compared using the general linear models for repeated measures statistical analysis.
No significant difference was found in the mean baseline excess body weight between the 2 groups (74 +/- 20 kg in the SMPP-compliant and 76 +/- 20 kg in the non-SMPP-compliant participants). The mean baseline body mass index (47 +/- 7 versus 48 +/- 72 kg/m(2) for the SMPP-compliant and non-SMPP-compliant participants) was also similar in the 2 groups. The postoperative follow-up rate was 94.5% at 1 month, 72.3% at 6 months, and 52.7% at 12 months. The excess weight loss was significantly greater in the SMPP compliant group than in the noncompliant group during the observed 12-month follow-up period (P = .04, by general linear models for repeated measures).
In a Medicaid population, implementation of an intensive preoperative SMPP resulted in a significant improvement in the short-term weight loss after Lap-Band placement.
在腹腔镜带手术前进行小组教育课程的效果尚未得到很好的定义。我们假设，在医疗补助人群中，完成标准化的 12 周多学科术前方案（SMPP）将显著改善术前和术后早期的减重效果。所有手术均在 2006 年至 2007 年期间在一所大学附属社区医院进行。
回顾性分析了 292 例行腹腔镜带放置术患者的前瞻性收集数据库。研究队列中的所有患者都被鼓励参加 SMPP，其中包括医疗、心理和营养干预。根据他们参加 SMPP 计划的情况，将患者分为 SMPP 符合组和非 SMPP 符合组。然后使用重复测量的一般线性模型统计分析比较这两组的术后减重效果。
两组患者的平均基线超重体重无显著差异（SMPP 符合组为 74 ± 20kg，非 SMPP 符合组为 76 ± 20kg）。两组患者的平均基线体重指数（SMPP 符合组为 47 ± 7kg/m²，非 SMPP 符合组为 48 ± 7kg/m²）也相似。术后 1 个月随访率为 94.5%，6 个月为 72.3%，12 个月为 52.7%。在观察到的 12 个月随访期间，SMPP 符合组的超重体重减轻明显大于非符合组（P =.04，通过重复测量的一般线性模型）。
在医疗补助人群中，实施强化术前 SMPP 可显著改善腹腔镜带放置术后的短期减重效果。
