General and Laparoscopic Surgery Unit, S. Giovanni Bosco Hospital, Naples, Italy.
Surg Obes Relat Dis. 2013 May-Jun;9(3):405-13. doi: 10.1016/j.soard.2012.11.011. Epub 2013 Jan 31.
There are few studies of long-term outcomes for either laparoscopic adjustable gastric banding (LAGB) or laparoscopic Roux-en-Y gastric bypass (LRYGB). The objective of this study was to compare outcomes of patients randomly assigned to undergo LAGB or LRYGB at 10 years.
LAGB, using the pars flaccida technique, and standard LRYGB were performed. From January 2000 to November 2000, 51 patients (mean age 34.0 ± 8.9 years; range 20-49) were randomly allocated to undergo either LAGB (n = 27, 5 men and 22 women; mean age 33.3 years; mean weight 120 kg; mean body mass index [BMI] 43.4 kg/m(2)) or LRYGB (n = 24, 4 men and 20 women; mean age 34.7; mean weight 120 kg; mean BMI 43.8 kg/m(2)). Data on complications, reoperations, weight, BMI, percentage of excess weight loss, and co-morbidities were collected yearly. The data were analyzed using Student's t test and Fisher's exact test, with P<.05 considered significant.
Five patients in the LAGB group and 3 patients in the LRYGB group were lost to follow-up. No patient died. Conversion to laparotomy was performed in 1 (4.2%) of 24 LRYGB patients. Reoperations were required in 9 (40.9%) of 22 LAGB patients and in 6 (28.6%) of the 21 LRYGB patients. At 10-year follow-up, the LRYGB patients had a greater percentage of mean excess weight loss than did the LAGB patients (69±29% versus 46±27%; P = .03).
LRYGB was superior to LAGB in term of excess weight loss results (76.2% versus 46.2%) at 10 years. However, LRYGB exposes patients to higher early complication rates than LAGB (8.3% versus 0%) and potentially lethal long-term surgical complications (internal hernia and bowel obstruction rate: 4.7%).
腹腔镜可调节胃束带术（LAGB）和腹腔镜 Roux-en-Y 胃旁路术（LRYGB）的长期结果研究甚少。本研究旨在比较随机接受 LAGB 或 LRYGB 治疗的患者在 10 年后的结果。
采用Pars Flaccida 技术进行 LAGB 和标准 LRYGB。2000 年 1 月至 2000 年 11 月，51 例患者（平均年龄 34.0±8.9 岁；范围 20-49 岁）被随机分配接受 LAGB（n=27，5 名男性和 22 名女性；平均年龄 33.3 岁；平均体重 120kg；平均 BMI 43.4kg/m2）或 LRYGB（n=24，4 名男性和 20 名女性；平均年龄 34.7；平均体重 120kg；平均 BMI 43.8kg/m2）。每年收集并发症、再次手术、体重、BMI、多余体重减轻百分比和合并症的数据。使用学生 t 检验和 Fisher 精确检验进行数据分析，P<.05 被认为具有统计学意义。
LAGB 组中有 5 例患者和 LRYGB 组中有 3 例患者失访。无患者死亡。24 例 LRYGB 患者中有 1 例（4.2%）转为剖腹手术。22 例 LAGB 患者中有 9 例（40.9%）和 21 例 LRYGB 患者中有 6 例（28.6%）需要再次手术。10 年随访时，LRYGB 患者的平均多余体重减轻百分比大于 LAGB 患者（69±29%比 46±27%；P=0.03）。
在 10 年时，LRYGB 在多余体重减轻结果（76.2%比 46.2%）方面优于 LAGB。然而，LRYGB 使患者面临更高的早期并发症发生率（8.3%比 0%）和潜在致命的长期手术并发症（内疝和肠梗阻发生率：4.7%）。
