Department of Psychosomatic Medicine, Innsbruck Medical University Hospital, Anichstrasse 35, A-6020 Innsbruck, Austria.
Eat Weight Disord. 2011 Dec;16(4):e250-6. doi: 10.1007/BF03327468. Epub 2011 May 24.
This study was performed to determine the long-term consequences of laparoscopic gastric banding on weight loss, body image, and life quality in morbidly obese patients. After a minimum follow-up of 9 years (mean follow-up 10 years; range 9-12 years) several questionnaires concerning weight loss, body image, and life quality were mailed to 180 morbidly obese patients following laparoscopic adjustable gastric banding. One hundred and twelve (62%) patients (92 females, 20 males) completed and returned the questionnaires. Of the entire sample, 73 (64.9%) patients still had the first band, 17 (15.3%) a second band, and in 22 (19.8%) probands the band had been removed for various reasons. Average weight loss, calculated as change in body mass index, was 13.9 kg/m². Average excess weight loss (EWL) was 30.6%. A total of 10% patients accounted for >50% of EWL. Half of the probands were completely satisfied with their weight loss and about half had reached their planned weight. Lowest post-operative weight was reached at different times, in nearly half of the probands after 2 years, in one-fourth after 4-5 years, and in about 20% at a later time. More than 90% of the probands experienced longer interruptions in weight loss; about half knew why. The findings indicate that overall quality of life was rated good to excellent by two-thirds of the probands, and fair to poor by one-third. A close correlation was seen between extent of weight loss and quality of life and body image. Despite some limitations, laparoscopic adjustable gastric banding is an effective and safe long-term surgical treatment for a majority of morbidly obese individuals, resulting in long-term weight loss and health-related quality of life. However, there is also a minority of morbidly obese subjects who do not benefit enough from this kind of bariatric surgery. Future research should investigate what kind of bariatric surgery is best for the particular obese individual in order to minimize unsatisfying post-operative results.
本研究旨在确定腹腔镜胃束带术对病态肥胖患者体重减轻、身体形象和生活质量的长期影响。在最低 9 年（平均随访 10 年；范围 9-12 年）的随访后，我们向 180 名接受腹腔镜可调胃束带术的病态肥胖患者邮寄了几份关于体重减轻、身体形象和生活质量的问卷。112 名（62%）患者（92 名女性，20 名男性）完成并返回了问卷。在整个样本中，73 名（64.9%）患者仍保留最初的胃束带，17 名（15.3%）保留第二个胃束带，22 名（19.8%）患者因各种原因已将胃束带去除。计算得出的平均体重减轻量（BMI 变化）为 13.9kg/m²。平均超重减轻率（EWL）为 30.6%。10%的患者体重减轻超过 50%。一半的患者对自己的体重减轻完全满意，大约一半的患者达到了他们的计划体重。术后最低体重出现在不同时间，近一半的患者在术后 2 年内达到最低体重，四分之一的患者在术后 4-5 年内达到最低体重，约 20%的患者在更晚时间达到最低体重。超过 90%的患者经历了更长时间的体重减轻中断；大约一半的患者知道原因。研究结果表明，三分之二的患者总体生活质量被评为良好至优秀，三分之一的患者评为一般至差。体重减轻的程度与生活质量和身体形象密切相关。尽管存在一些局限性，但腹腔镜可调胃束带术对大多数病态肥胖患者来说是一种有效和安全的长期手术治疗方法，可长期减轻体重和改善与健康相关的生活质量。然而，也有少数病态肥胖患者没有从这种减重手术中获益。未来的研究应该调查哪种减重手术最适合特定的肥胖个体，以尽量减少术后不满意的结果。
