Department of Surgery, Centre Hospitalier Emile Mayrisch (CHEM), Esch-sur-Alzette, Luxembourg.
Langenbecks Arch Surg. 2012 Dec;397(8):1235-41. doi: 10.1007/s00423-012-0945-5. Epub 2012 Mar 20.
Unsatisfactory patient compliance and unfavorable results of weight loss let centers prefer the Roux-en-Y gastric bypass (RYGB) as a combined restrictive and malabsorptive procedure. The aim of this study was to evaluate results of laparoscopic adjustable gastric banding (LAGB) versus laparoscopic RYGB.
The study was conducted at Centre Hospitalier Emil Mayrisch Clinic for specialized care (n = 618 beds) in Luxembourg (South).
Of 620 procedures, 204 patients had LAGB and 416 LRYGB. Short-term (t(1), 6 months to 2 years), middle-term (t(2), 2 to 5 years), and long-term follow-up (t(3), >5 years) were performed, including weight loss evolution, Bariatric Analysis, and Reporting Outcome System (BAROS).
Percent EBWL mean values for LAGB vs. LRYGB were at t(1) 64.3 vs. 79.5, p = 0.01; at t(2) 49.4 vs. 91, p < 0.0001; and at t(3) 52.6 vs. 79.9, p < 0.0001. The BAROS mean values were at t(1) 3.81 vs. 4.00, p = 0.183; at t(2) 3.57 vs. 4.12, p < 0.001; and at t(3) 3.71 vs. 4.04, p = 0.02. Major complication rate (<30 days) was similar (p = 0.601). Long-term (>30 days) complications were more common after LAGB (14.3 versus 3.6%, p < 0.001). Fifty patients (25%) required a second and 36 patients (18%) a third operation (LRYGB).
The significant difference in %EBWL and BAROS and late adverse events with high re-operation rates in LAGB made the LRYGB more attractive.
由于患者依从性差和减肥效果不理想，中心更倾向于选择 Roux-en-Y 胃旁路术（RYGB）作为一种联合限制和吸收不良的手术。本研究旨在评估腹腔镜可调胃束带术（LAGB）与腹腔镜 RYGB 的结果。
本研究在卢森堡（南部）的 Emil Mayrisch 临床中心专科医院（有 618 张病床）进行。
在 620 例手术中，204 例患者接受了 LAGB，416 例患者接受了 LRYGB。进行了短期（t（1），6 个月至 2 年）、中期（t（2），2 至 5 年）和长期随访（t（3），>5 年），包括体重减轻演变、减肥分析和报告结果系统（BAROS）。
LAGB 与 LRYGB 的平均百分比 EBWL 值在 t（1）时分别为 64.3%和 79.5%，p=0.01；在 t（2）时分别为 49.4%和 91%，p<0.0001；在 t（3）时分别为 52.6%和 79.9%，p<0.0001。BAROS 的平均数值在 t（1）时分别为 3.81 和 4.00，p=0.183；在 t（2）时分别为 3.57 和 4.12，p<0.001；在 t（3）时分别为 3.71 和 4.04，p=0.02。主要并发症发生率（<30 天）相似（p=0.601）。长期（>30 天）并发症在 LAGB 后更为常见（14.3%比 3.6%，p<0.001）。50 例患者（25%）需要进行第二次手术，36 例患者（18%）需要进行第三次手术（LRYGB）。
LAGB 在 %EBWL 和 BAROS 方面的显著差异以及晚期不良事件发生率较高导致再次手术率较高，使得 LRYGB 更具吸引力。
