SRH Municipal Hospital, Gera, Germany,
Obes Surg. 2014 Jan;24(1):9-14. doi: 10.1007/s11695-013-1068-y.
Since 1 January 2005, the outcomes of bariatric surgeries have been examined in Germany. All data are registered prospectively in cooperation with the Institute of Quality Assurance in Surgery at Otto-von-Guericke University Magdeburg.
Data are collected in an online data bank. Data collection began in 2005 for the results of gastric banding (GB) and in 2006 for sleeve gastrectomies (SGs). In addition to primary bariatric operations, data regarding the complications of revision procedures and redo operations have been analyzed. Participation in the quality assurance study is required for all certified centers in Germany.
SGs are a popular redo operation after failed gastric banding. Using the German Bariatric Surgery Registry, we analyzed data from 137 SGs that were used in a one-step approach after GB and 37 SGs that were used in a two-step approach. Leakage rates for primary SGs dropped to 1.9 %. The incidence of leakage after a one-step SG after GB is significantly higher (4.4 %) than for a two-step approach (0 %).
SGs are popular procedures after failed GB in Germany, but the complication rates for one-step band removal are higher than for a two-step approach. After examining the data, we suggest performing band removal and SG as a two-step procedure. Further analysis is necessary to evaluate the optimal time period between band removal and SG. Follow-up investigations must be performed to determine if SG is an effective and safe option after GB.
自 2005 年 1 月 1 日起，德国开始对减重手术的结果进行检查。所有数据均与马格德堡奥托·冯·格里克大学外科学质量保证研究所合作进行前瞻性登记。
数据在在线数据库中收集。2005 年开始收集胃带（GB）的结果数据，2006 年开始收集袖状胃切除术（SGs）的数据。除了主要的减肥手术外，还分析了与修订程序和再次手术相关的并发症数据。德国所有认证中心都必须参与质量保证研究。
SG 是 GB 失败后的一种流行的再次手术。使用德国减肥手术登记处，我们分析了 137 例用于 GB 后一步法的 SG 和 37 例用于两步法的 SG 的数据。原发性 SG 的漏率降至 1.9%。GB 后一步法 SG 的漏率（4.4%）明显高于两步法（0%）。
SG 是德国 GB 失败后的常用手术，但一步法带去除的并发症发生率高于两步法。在检查数据后，我们建议将带去除和 SG 作为两步法进行。需要进一步分析以评估带去除和 SG 之间的最佳时间间隔。需要进行随访调查以确定 SG 是否是 GB 后的有效和安全选择。
