Department of Abdominal and Minimally Invasive Surgery, Vaasa Central Hospital, Vaasa Hospital District, Finland; University of Turku, Vaasa Central Hospital, Turku, Finland.
Surg Obes Relat Dis. 2013 Sep-Oct;9(5):753-7. doi: 10.1016/j.soard.2013.05.010. Epub 2013 Jun 14.
Many studies of short-term to mid-term outcomes after laparoscopic adjustable gastric banding (LAGB) have been published, but reliable long-term outcome reports with a minimum follow up ≥ 10 years in a sufficient number of included patients are still scarce. The objective of this study was to evaluate the long-term results after LAGB.
Sixty consecutive patients (44 women, 16 men) were treated for morbid obesity by LAGB between 1996 and 1999. Median age of the patients at the time of operation was 45 years (range 21-64). Median preoperative body mass index (BMI, kg/m(2)) was 45 (range 35-55). All patients were asked to adhere to a strict follow-up program. Patients' BMI and percentage excess weight loss (%EWL) were calculated in the hospital's database for bariatric patients, and excess weight was taken as the weight in kilograms above the weight at BMI of 25 kg/m(2).
Complete data on all 60 patients could be assessed; thus, the overall rate of follow-up was 100%. After a median (range) follow-up of 14.1 years (13.2-16.8 years), the mean BMI (SD) dropped from 45 (5) to 36 (6) kg/m(2), with a mean (SD) EWL of 49% (29). At 15 years of follow-up, 29 (48%) bands have been removed, and 38 (63%) reoperations have been performed in 29 (48%) patients. Almost 70% received further treatment for their morbid obesity after band removal. Of those patients with the band still in place at 14 years, 40% had more than 50% EWL and 20% had less than 25% EWL. There was no mortality related to the primary or revisional operations, but 2 patients died of unrelated causes.
Mean %EWL after LAGB after more than 14 years was fairly good-49%. However, a reoperation rate of more than 60% in 48% of the patients and a band removal rate of almost 50% may indicate that LAGB cannot be recommended as a primary procedure to the general morbidly obese population.
腹腔镜可调节胃束带术（LAGB）的短期和中期结果已有许多研究报道，但可靠的长期结果报告，包括足够数量的患者，随访时间至少 10 年，仍然很少。本研究的目的是评估 LAGB 的长期结果。
1996 年至 1999 年间，60 例连续接受腹腔镜可调节胃束带术（LAGB）治疗的病态肥胖患者（44 名女性，16 名男性）纳入研究。手术时患者的中位年龄为 45 岁（范围 21-64 岁）。术前中位体重指数（BMI，kg/m2）为 45（范围 35-55）。所有患者均被要求严格遵循随访计划。在医院的减重患者数据库中计算患者的 BMI 和超重减轻百分比（%EWL），超重以超过 BMI 为 25 kg/m2 时体重的公斤数计算。
可评估 60 例患者的所有完整数据；因此，总体随访率为 100%。中位（范围）随访 14.1 年（13.2-16.8 年）后，平均 BMI（SD）从 45（5）降至 36（6）kg/m2，平均（SD）EWL 为 49%（29）。15 年随访时，29 例（48%）患者已取出束带，29 例（48%）患者中有 38 例（63%）再次手术。几乎 70%的患者在束带取出后需要进一步治疗其病态肥胖。在 14 年时仍保留束带的患者中，40%的患者有超过 50%的 EWL，20%的患者有少于 25%的 EWL。无与原发性或再次手术相关的死亡，但有 2 例患者死于非相关原因。
LAGB 术后 14 年以上的平均 EWL 相当好（49%）。然而，48%的患者中有 60%以上需要再次手术，几乎 50%的患者需要取出束带，这可能表明 LAGB 不能作为一般病态肥胖人群的主要治疗方法。
