Department of Surgery, Fletcher Allen Healthcare, University of Vermont College of Medicine, Burlington, Vermont 05401, USA.
Surg Obes Relat Dis. 2010 Nov-Dec;6(6):597-600. doi: 10.1016/j.soard.2010.09.008. Epub 2010 Sep 17.
Despite the 2008 "American Association of Clinical Endocrinologists, The Obesity Society, and American Society for Metabolic and Bariatric Surgery Medical Guidelines for Clinical Practice for the Perioperative Nutritional, Metabolic, and Nonsurgical Support of the Bariatric Surgery Patient," consensus does not exist for postoperative care in laparoscopic adjustable gastric banding (LAGB) patients (grade D evidence). It has been suggested that regular follow-up is related to better outcomes, specifically greater weight loss. The aim of the present study was to investigate the effects of travel distance to the clinic on the adherence to follow-up visits and weight loss in a cohort of LAGB patients in the setting of a rural, university-affiliated teaching hospital in the United States.
A retrospective chart review was performed of all consecutive LAGB patients for a 1-year period. Linear regression analysis was used to identify the relationships between appointment compliance and the distance traveled and between the amount of weight loss and the distance traveled.
Linear regression analysis was performed to investigate the effect of the travel distance to the clinic on the percentage of follow-up visits postoperatively. This effect was not significant (P = .4). Linear regression analysis was also performed to elucidate the effect of the travel distance to the clinic on the amount of weight loss. This effect was significant (P = .04).
The travel distance to the clinic did not seem to be a significant predictor of compliance in a cohort of LAGB patients with ≤ 1 year of follow-up in a rural setting. However, a weak relationship was found between the travel distance to the clinic and weight loss, with patients who traveled further seeming to lose slightly more weight.
尽管有 2008 年的“美国临床内分泌医师协会、肥胖协会和美国代谢与减肥外科学会医疗指南，用于肥胖症患者手术前后的营养、代谢和非手术支持”，但腹腔镜可调节胃束带术（LAGB）患者的术后护理仍未达成共识（D 级证据）。有人认为，定期随访与更好的结果有关，特别是体重减轻更多。本研究旨在调查距离诊所的旅行距离对美国农村大学附属医院 LAGB 患者随访和体重减轻的影响。
对所有连续的 LAGB 患者进行了为期 1 年的回顾性图表审查。线性回归分析用于确定预约遵守与旅行距离之间的关系，以及体重减轻量与旅行距离之间的关系。
进行线性回归分析以研究到诊所的旅行距离对术后随访的百分比的影响。该影响不显著（P =.4）。还进行了线性回归分析以阐明到诊所的旅行距离对体重减轻量的影响。这种影响是显著的（P =.04）。
在农村地区，对接受 ≤ 1 年随访的 LAGB 患者队列进行分析，到诊所的旅行距离似乎不是遵守率的重要预测因素。然而，发现到诊所的旅行距离与体重减轻之间存在微弱的关系，旅行距离较远的患者似乎体重减轻略多。
