General Surgical Department, Norfolk and Norwich University Hospital, Colney Lane, Norwich, NR4 7UY, UK.
Surg Endosc. 2010 Oct;24(10):2432-8. doi: 10.1007/s00464-010-0970-9. Epub 2010 Mar 13.
In this study we examine the importance of regular postoperative follow-up and the effect of geographical distance from the centre of follow-up on long-term weight loss after laparoscopic adjustable gastric banding (LAGB).
Between 1997 and 2009, 150 patients underwent LAGB. Postoperatively, patients were invited to attend a monthly nurse-led follow-up clinic to assess weight loss and make necessary band adjustments. Demographic data and weight loss at each follow-up appointment were prospectively entered into a database. Percent excess weight loss (%EWL), number of follow-ups per patient, and the distance each patient had to travel to the surgical centre were calculated.
One hundred thirty-seven females and 13 males with a median age of 45 years, median weight of 121 kg, and median BMI of 45 have had surgery to date. Median operative time was 35 min and median length of hospital stay was 1 night. Median %EWL at 1, 3, 6, 9, 12, 24, and 36 months postoperatively was 10, 17, 26, 37, 54, 64, and 76%, respectively. Median %EWL at 12 months after LABG grouped by 1-3, 4-6, 7-9, and more than 10 follow-up attendances was 41, 48, 54, and 69%, respectively. At a median of 12 months postoperatively, at 0-10, 10-20, 20-30, and more than 30 miles from the centre of follow-up, median %EWL was 54, 57, 52, and 49%, respectively, and median number of follow-up attendances at those distances was 10, 8, 5, and 5, respectively.
With good local follow-up, weight loss after LABG can rival that achieved with more invasive procedures. Follow-up is an important determinant for weight loss after LABG. Patients attend fewer follow-up clinics with increasing distance from the centre of follow-up.
本研究旨在探讨腹腔镜可调节胃束带术（LAGB）后定期术后随访的重要性，以及距随访中心的地理距离对长期减重效果的影响。
1997 年至 2009 年间，共 150 例患者接受了 LAGB 手术。术后，患者被邀请参加每月一次的护士主导的随访诊所，以评估体重减轻情况并进行必要的带调整。人口统计学数据和每次随访时的体重减轻情况均被前瞻性地录入数据库。计算每位患者的超重百分比（%EWL）、每位患者的随访次数和每位患者前往手术中心的距离。
迄今为止，共有 137 名女性和 13 名男性接受了手术，中位年龄为 45 岁，中位体重为 121 公斤，中位 BMI 为 45。中位手术时间为 35 分钟，中位住院时间为 1 晚。术后 1、3、6、9、12、24 和 36 个月的中位%EWL 分别为 10%、17%、26%、37%、54%、64%和 76%。LAGB 术后 12 个月，按 1-3、4-6、7-9 和 10 次以上随访分组，中位%EWL 分别为 41%、48%、54%和 69%。术后 12 个月，距随访中心 0-10、10-20、20-30 和 30 英里以上的中位%EWL 分别为 54%、57%、52%和 49%，相应的随访次数分别为 10、8、5 和 5。
在良好的本地随访条件下，LAGB 术后的减重效果可与更具侵袭性的手术相媲美。随访是 LAGB 术后体重减轻的重要决定因素。随着与中心距离的增加，患者参加的随访次数减少。
