Department of Gastrointestinal Surgery, Vaasa Central Hospital, Vaasa, Finland.
Scand J Surg. 2012;101(3):184-9. doi: 10.1177/145749691210100308.
We report the results for the first consecutive 360 Roux-en-Y gastric by-pass (RYGB) operations performed in a district hospital in Finland.
Demographic data, perioperative characteristics, and follow-up data were entered prospectively in the hospital's database for bariatric patients.
We performed 325 primary laparoscopic Roux-en-Y gastric bypass (LRYGB) operations, one open RYGB, and 34 revisions. Mean BMI before the operations was 47.5 ± 7.8 kg/m2 (31.5-91.0 kg/m2). The percentage of patients with type 2 diabetes mellitus (T2DM) was high; 52.3% (170 patients). The mean operative time decreased from 110 minutes during the first 108 operations to 82 minutes for the second 108 operations, and to 74 minutes for the last 109 operations (P < 0.001). Postoperative hospital stay was significantly reduced (P < 0.001) for the last 109 patients compared to the first and second group of patients. Overall morbidity averaged 19.1% (62/325). Severe complications were detected in 15 patients (4.6%). There was a tendency to more serious complications in the first group of patients. There was one death (mortality 0.3%). With a follow-up rate of 97% at 3 months T2DM had resolved in 48.2%, and had resolved or improved in a minimum of 92.9% of the diabetic patients. Weight loss (WL) and excess weight loss (EWL) averaged 20% and 46% respectively.
Operative time and postoperative hospital stay decrease significantly with increasing experience. The first one hundred patients may be at higher risk for complications. LRYGB operations may have an important impact on the resolution of T2DM in the operated population.
我们报告了在芬兰一家地区医院首次连续进行的 360 例 Roux-en-Y 胃旁路术(RYGB)的结果。
人口统计学数据、围手术期特征和随访数据在医院的减重患者数据库中进行前瞻性录入。
我们进行了 325 例腹腔镜下 Roux-en-Y 胃旁路术(LRYGB)、1 例开放 RYGB 和 34 例翻修手术。术前平均 BMI 为 47.5 ± 7.8 kg/m2(31.5-91.0 kg/m2)。2 型糖尿病(T2DM)患者比例较高,为 52.3%(170 例)。手术时间从前 108 例的 110 分钟逐渐减少到第 2 组的 108 例的 82 分钟,最后 109 例的 74 分钟(P < 0.001)。与前两组相比,最后 109 例患者的术后住院时间显著缩短(P < 0.001)。总体发病率平均为 19.1%(62/325)。15 例(4.6%)发现严重并发症。第一组患者有发生更严重并发症的趋势。有 1 例死亡(死亡率 0.3%)。在 3 个月的随访中,糖尿病缓解率为 48.2%,至少有 92.9%的糖尿病患者的糖尿病得到缓解或改善。体重减轻(WL)和多余体重减轻(EWL)平均分别为 20%和 46%。
随着经验的增加,手术时间和术后住院时间显著减少。前 100 例患者可能存在更高的并发症风险。LRYGB 手术可能对手术人群中 2 型糖尿病的缓解产生重要影响。