Department of General Surgery, Rush University Medical Center, 1653 W Congress Pkwy, Chicago, IL 60612, USA.
Obes Surg. 2012 Dec;22(12):1880-3. doi: 10.1007/s11695-012-0748-3.
Laparoscopic adjustable gastric banding is an effective procedure for weight loss. Long-term follow-up and band adjustments are crucial to achieve sustained weight loss, but the optimal frequency is unknown. We compare the weight loss of two patient groups adjusted at different frequencies. A 24-month analysis was conducted to 280 patients (156 from an academic center and 124 from an outpatient surgery center). Each center's patients were stratified into 6-month groups according to the length of follow-up. These groups were compared between the settings for average adjustments per month and percent excess weight loss (%EWL). Patient subgroup 0-6 months had 0.6 adjustments/month (adj/mo) and 18.3% EWL at AC compared to 0.7 adj/mo and 19.1% EWL at OC. Subgroup 6-12 months had 0.4 adj/mo and 27.2% EWL at AC compared to 0.5 adj/mo and 33.4% EWL at OC. Subgroup 12-18 months had 0.3 adj/mo and 25.3% EWL at AC compared to 0.5 adj/mo and 45.6% EWL at OC. Subgroup 18-24 months had 0.3 adj/mo and 30.9% EWL at AC compared to 0.3 adj/mo and 42.2% EWL at OC. Analysis of variance crossing 6-month groups with facility produced significant effects for groups (F = 15.52, df = 4.290, p < 0.001), center (F = 14.28, df = 1.290, p < 0.001), and the center-by-group interaction (F = 3.01, df = 4.290, p < 0.02). Our data suggest that more frequent adjustments result in increased EWL, but optimal frequency remains unknown. We believe that the difference noted between the clinics stems from accessibility to adjustments. Additional data, such as %EWL at smaller monthly intervals and the point of diminishing results, should be investigated in future studies.
腹腔镜可调节胃束带术是一种有效的减肥方法。长期随访和束带调整对于实现持续减肥至关重要，但最佳频率尚不清楚。我们比较了两组以不同频率调整的患者的减肥效果。对 280 名患者进行了 24 个月的分析（156 名来自学术中心，124 名来自门诊手术中心）。根据随访时间的长短，每个中心的患者分为 6 个月组。在设定的每月平均调整次数和多余体重百分比（%EWL）方面比较了这两个组。患者亚组 0-6 个月时，AC 组的调整次数为 0.6 次/月（adj/mo），EWL 为 18.3%，而 OC 组的调整次数为 0.7 adj/mo，EWL 为 19.1%。亚组 6-12 个月时，AC 组的调整次数为 0.4 adj/mo，EWL 为 27.2%，OC 组的调整次数为 0.5 adj/mo，EWL 为 33.4%。亚组 12-18 个月时，AC 组的调整次数为 0.3 adj/mo，EWL 为 25.3%，OC 组的调整次数为 0.5 adj/mo，EWL 为 45.6%。亚组 18-24 个月时，AC 组的调整次数为 0.3 adj/mo，EWL 为 30.9%，OC 组的调整次数为 0.3 adj/mo，EWL 为 42.2%。跨 6 个月组与设施的方差分析产生了显著的组间效应（F=15.52，df=4.290，p<0.001）、中心（F=14.28，df=1.290，p<0.001）和中心-组间相互作用（F=3.01，df=4.290，p<0.02）。我们的数据表明，更频繁的调整会导致 EWL 增加，但最佳频率仍不清楚。我们认为诊所之间的差异源于调整的可及性。未来的研究应该调查更小的月间隔的 EWL 百分比和效果递减的点等其他数据。
