Bariatric Surgery Unit, Homerton University Hospital, London, United Kingdom.
Bariatric Surgery Unit, Homerton University Hospital, London, United Kingdom.
Surg Obes Relat Dis. 2014 Jan-Feb;10(1):155-60. doi: 10.1016/j.soard.2013.05.005. Epub 2013 Jun 2.
Recently, the Food and Drug Administration (FDA) panel approved laparoscopic adjustable gastric banding (LAGB) in patients with a body mass index (BMI) ≥30 kg/m(2) and related co-morbidities. To our knowledge there is no systematic review assessing LAGB in this group. The objective of this study was to analyze the use of LAGB in patients with BMI ≤35 kg/m(2).
The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used to systematically search MEDLINE and Embase using the medical subject headings (MeSH) terms "bariatric surgery" and "obese" with equivalent free text searches and cross-references. Studies that described LAGB in patients with BMI ≤35 kg/m(2) were reviewed with particular focus on weight loss after LAGB as well as morbidity/mortality, co-morbidity resolution.
Six studies evaluating 515 patients were included. Mean percentage excess weight loss (%EWL) ranged from 52.5 (±13.2) to 78.6 (±9.4) at 1 year and 57.6 (±29.3) to 87.2 (±9.5) at 2 years postoperatively. Two studies reported weight loss at 3 years with mean %EWL of 53.8 (±32.8) to 64.7 (±12.2). The only study with follow-up data after 3 years reported a mean %EWL of 68.8 (±15.3) and 71.9 (±10.7) at 4 and 5 years, respectively. Thirty-four patients (6.6%) developed complications. There was 1 reported mortality (.19%), which occurred at 20 months postoperatively.
This systematic review shows that LAGB is well tolerated and effective in patients with a BMI ≤35 kg/m(2). There are encouraging suggestions that co-morbidities show partial or total resolution; however, a paucity of data remains in this BMI group, particularly with regard to long-term outcomes.
最近，美国食品和药物管理局（FDA）小组批准了腹腔镜可调节胃束带术（LAGB）用于身体质量指数（BMI）≥30kg/m²且伴有相关合并症的患者。据我们所知，目前尚无系统评价评估 BMI≤35kg/m²患者的 LAGB。本研究的目的是分析 LAGB 在 BMI≤35kg/m²患者中的应用。
使用 Preferred Reporting Items for Systematic Reviews and Meta-Analyses（PRISMA）指南，通过 MEDLINE 和 Embase 检索，使用医学主题词（MeSH）术语“减肥手术”和“肥胖”进行系统检索，并辅以等效的自由文本搜索和交叉引用。评估 BMI≤35kg/m²患者中 LAGB 的研究，并特别关注 LAGB 后的体重减轻情况以及发病率/死亡率、合并症缓解情况。
纳入了 6 项评估 515 例患者的研究。术后 1 年时，52.5%（±13.2）至 78.6%（±9.4），2 年时 57.6%（±29.3）至 87.2%（±9.5）的患者达到了超重体重减轻百分比（%EWL）。有 2 项研究报告了术后 3 年的体重减轻数据，平均 %EWL 为 53.8%（±32.8）至 64.7%（±12.2）。唯一一项随访时间超过 3 年的研究报告，4 年和 5 年时的平均 %EWL 分别为 68.8%（±15.3）和 71.9%（±10.7）。34 例（6.6%）患者发生并发症。报告了 1 例死亡率（0.19%），发生在术后 20 个月。
本系统评价显示，LAGB 对 BMI≤35kg/m²的患者耐受良好且有效。有令人鼓舞的证据表明合并症部分或全部缓解；然而，该 BMI 组的数据仍然很少，尤其是在长期结果方面。
