Columbia University at Harlem Hospital Center, New York, NY 10037, USA.
Obes Surg. 2011 Sep;21(9):1337-43. doi: 10.1007/s11695-011-0402-5.
While some studies have shown that long-limb gastric bypass with Roux limb length of 150 to 200 cm can attain better weight loss outcomes in super-obese patients (BMI >50 kg/m(2)) than the standard limb gastric bypass with Roux limb length of 100 to 150 cm, other studies have not shown similar findings. Additionally, no study has demonstrated the optimal length of the Roux limb that will result in ideal weight loss. The purpose of this study is to compare the long-term weight loss and weight regain of standard limb length (SLL) and long limb length (LLL) gastric bypass in patients with BMI >50 kg/m(2).
A total of 120 patients with BMI >50 kg/m(2) underwent either SLL (total bypass length = 200, biliopancreatic limb = 50-80 cm, Roux limb = 120-150 cm) or LLL (total bypass length = 250 biliopancreatic limb = 50-80 cm, Roux limb = 170-200 cm) RYGB. The excess weight loss (EWL), the weight regain, and the rate of complications were measured at 1-, 2-, and 3-year follow-up. Statistical comparisons were performed using t-test.
There was no difference in patient demographics, pre-operative BMI, or comorbidities between the two groups: SLL (n = 55) and LLL (n = 65). In comparing standard- to long-limb cohorts, preoperative BMI was 56.1 ±5.34 vs. 57.5 ± 6.05 kg/m(2), respectively. There was no statistical difference in percent EWL at 1, 2, and 3 years between the two groups [55.2 vs. 55 (P = 0.933), 61.5 vs. 60.8 (P = 0.831), and 61.1 vs.60 (P = 0.932)]. There was no difference in percent weight regain between the two groups, 11.2 (SLL) and 5.2 (LLL) (P = 0.13). The rates of complications were similar in the two groups.
There is no difference in weight loss or weight regain between the SLL and LLL RYGB. Longer-limb gastric bypass is not required in patients with BMI >50 kg/m(2) for them to obtain long-term, sustained weight loss.
虽然一些研究表明，对于 BMI>50kg/m² 的超肥胖患者（BMI>50kg/m²），长肢胃旁路术（Roux 肢长度 150-200cm）比标准肢胃旁路术（Roux 肢长度 100-150cm）能获得更好的减重效果，但其他研究并未得出类似结果。此外，尚无研究表明哪种 Roux 肢长度能达到理想的减重效果。本研究旨在比较标准肢长（SLL）和长肢长（LLL）胃旁路术在 BMI>50kg/m²患者中的长期减重效果和体重反弹情况。
共有 120 名 BMI>50kg/m²的患者接受了 SLL（总旁路长度=200cm，胆胰支=50-80cm，Roux 支=120-150cm）或 LLL（总旁路长度=250cm，胆胰支=50-80cm，Roux 支=170-200cm）RYGB。在 1、2、3 年随访时，测量超重体重减轻（EWL）、体重反弹和并发症发生率。使用 t 检验进行统计学比较。
两组患者的人口统计学资料、术前 BMI 和合并症无差异：SLL（n=55）和 LLL（n=65）。标准肢长与长肢长组患者术前 BMI 分别为 56.1±5.34kg/m²和 57.5±6.05kg/m²。两组患者在 1、2、3 年的 EWL 百分比上无统计学差异[55.2% vs. 55%（P=0.933）、61.5% vs. 60.8%（P=0.831）和 61.1% vs. 60%（P=0.932）]。两组患者体重反弹百分比无差异，分别为 11.2%（SLL）和 5.2%（LLL）（P=0.13）。两组患者的并发症发生率相似。
SLL 和 LLL RYGB 之间的减重或体重反弹无差异。对于 BMI>50kg/m²的患者，不需要进行更长肢的胃旁路术，即可获得长期持续的减重效果。
