Hall J C, Watts J M, O'Brien P E, Dunstan R E, Walsh J F, Slavotinek A H, Elmslie R G
Department of Surgery, Flinders Medical Centre, Royal Adelaide Hospital, South Australia.
Ann Surg. 1990 Apr;211(4):419-27. doi: 10.1097/00000658-199004000-00007.
The efficacy of three gastric restriction operations were compared in a prospective randomized study of 310 morbidly obese subjects. The median patient age was 34 years (range, 18 to 62 years). They were predominantly female (13:1) and had a median pre-operative weight that was 198% of their ideal weight (range, 160% to 318%). There was an equitable dispersion of perceived risk factors between the groups under study and there were no deaths during the perioperative period. Compliance with follow-up at 3 years was 91%. When success was defined as a loss of more than 50% of excess weight or a current pregnancy, the success rates at 3 years were 17% for gastrogastrostomy, 48% for vertical gastroplasty, and 67% for Roux-en-Y gastric bypass (p less than 0.001). Although the gastric bypass operation took longer to perform, there were similar outcome patterns for the three groups during the postoperative period. We conclude that the Roux-en-Y gastric bypass is the preferred procedure for the surgical treatment of morbid obesity.
在一项针对310名病态肥胖受试者的前瞻性随机研究中，对三种胃限制手术的疗效进行了比较。患者年龄中位数为34岁（范围18至62岁）。他们以女性为主（比例为13:1），术前体重中位数是其理想体重的198%（范围160%至318%）。研究中的各小组之间感知到的风险因素分布均衡，围手术期无死亡病例。三年随访的依从率为91%。当成功定义为超重减轻超过50%或当前怀孕时，三年时胃胃吻合术的成功率为17%，垂直胃成形术为48%，Roux-en-Y胃旁路术为67%（p<0.001）。尽管胃旁路手术的实施时间更长，但术后三组的结果模式相似。我们得出结论，Roux-en-Y胃旁路术是外科治疗病态肥胖的首选术式。
