Italian Group for LapBand, Città della Scienza, Naples, Italy.
Surg Endosc. 2010 Jul;24(7):1519-23. doi: 10.1007/s00464-009-0669-y. Epub 2010 Mar 31.
Retrospective multicenter analysis of the results of two different approaches for band positioning: perigastric and pars flaccida.
Data were collected from the database of the Italian Group for LapBand (GILB). Patients operated from January 2001 to December 2004 were selected according to criteria of case-control studies to compare two different band positioning techniques: perigastric (PG group) and pars flaccida (PF group). Demographics, laparotomic conversion, postoperative complications, and weight loss parameters were considered. Data are expressed as mean +/- standard deviation.
2,549 patients underwent the LapBand System procedure [age: 40 +/- 11.7 years; sex: 2,130 female, 419 male; body mass index (BMI): 46.4 +/- 6.9 kg/m(2); excess weight (EW): 60.1 +/- 23.6 kg; %EW: 90.1 +/- 32.4]. During this period 1,343/2,549 (52.7%) were operated via the pars flaccida (PF group) and 1,206/2,549 (47.3%) via the perigastric approach (PG group). Demographics for both groups were similar. Thirty-day mortality was absent in both groups. Operative time was significantly longer in the PG group (80 +/- 20 min versus 60 +/- 40 min; p < 0.05). Hospital stay was similar in the two groups (2 +/- 2 days). Laparotomic conversion was significantly higher in the PG group (6 versus 2 patients; p < 0.001). Overall postoperative complication rate was 172/2,549 (6.7%) and was linked to gastric pouch dilation/slippage (67/172), intragastric migration/erosion (17/172), and tube/port failure (88/172). Gastric pouch dilation and intragastric migration were significantly more frequent in the PG group: 47 versus 20 (p < 0.001) and 12 versus 5 (p < 0.001), respectively. Patients eligible for minimum 3-year follow-up were 1,118/1,206 (PG group) and 1,079/1,343 (PF group). Mean BMI was 33.8 +/- 12.1 kg/m(2) (PG group) and 32.4 +/- 11.7 kg/m(2) (PF group) (p = ns), and mean percentage excess weight loss (%EWL) was 47.2 +/- 25.4 and 48.9 +/- 13.2 in PG and PF groups, respectively (p = ns).
Significant improvement in LapBand System results with regard to laparotomic conversion and postoperative complication rate, with similar weight loss results, was observed in the pars flaccida group.
回顾性分析两种不同胃 bands 定位方法（胃周和胃壁薄弱区）的结果。
从意大利胃带组（GILB）数据库中收集数据。根据病例对照研究的标准，选择 2001 年 1 月至 2004 年 12 月期间接受手术的患者，比较两种不同的 bands 定位技术：胃周（PG 组）和胃壁薄弱区（PF 组）。考虑人口统计学、剖腹术转换、术后并发症和体重减轻参数。数据表示为平均值 +/- 标准差。
2549 例患者接受了 LapBand 系统手术[年龄：40 +/- 11.7 岁；性别：2130 名女性，419 名男性；体重指数（BMI）：46.4 +/- 6.9 kg/m²；超重（EW）：60.1 +/- 23.6 公斤；%EW：90.1 +/- 32.4]。在此期间，1343/2549（52.7%）通过胃壁薄弱区（PF 组）和 1206/2549（47.3%）通过胃周途径（PG 组）进行手术。两组的人口统计学数据相似。两组均无 30 天死亡率。PG 组的手术时间明显较长（80 +/- 20 分钟与 60 +/- 40 分钟；p < 0.05）。两组的住院时间相似（2 +/- 2 天）。PG 组剖腹术转换率明显更高（6 例与 2 例；p < 0.001）。总体术后并发症发生率为 2549 例中的 172 例（6.7%），与胃囊扩张/滑脱（67/172）、胃内迁移/侵蚀（17/172）和管/端口故障（88/172）有关。PG 组胃囊扩张和胃内迁移的发生率明显更高：47 例与 20 例（p < 0.001）和 12 例与 5 例（p < 0.001）。有资格接受至少 3 年随访的患者为 1118/1206（PG 组）和 1079/1343（PF 组）。平均 BMI 为 33.8 +/- 12.1 kg/m²（PG 组）和 32.4 +/- 11.7 kg/m²（PF 组）（p = ns），PG 组和 PF 组的平均超重百分比减轻（%EWL）分别为 47.2 +/- 25.4 和 48.9 +/- 13.2（p = ns）。
胃壁薄弱区组的剖腹术转换和术后并发症发生率显著改善，体重减轻结果相似。
