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腹腔镜可调节胃束带折叠术:来自美国单一中心的病例匹配研究。

Laparoscopic adjustable gastric banded plication: case-matched study from a single U.S. center.

作者信息

Chaudhry Umer I, Osayi Sylvester N, Suzo Andrew J, Noria Sabrena F, Mikami Dean J, Needleman Bradley J

机构信息

Center for Minimally Invasive Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio.

Center for Minimally Invasive Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio.

出版信息

Surg Obes Relat Dis. 2015 Jan-Feb;11(1):119-24. doi: 10.1016/j.soard.2014.05.030. Epub 2014 Jun 4.

Abstract

BACKGROUND

Laparoscopic adjustable gastric banded plication (LAGBP) is a novel technique for weight loss surgery. This study evaluates the safety and short-term efficacy of LAGBP in a U.S. population. The setting was an academic medical center in the United States.

METHODS

Patients who underwent LAGBP between 2012 and 2013 were reviewed retrospectively. Demographic characteristics, pre and perioperative details, body mass index (BMI), and percent excess weight loss (%EWL) were analyzed and compared to case-matched cohorts that had laparoscopic adjustable gastric banding (LAGB) or laparoscopic sleeve gastrectomy (LSG) during the same time period.

RESULTS

Seventeen patients (14 females) underwent LAGBP during the study period and were case-matched based on age, sex, race, and preoperative BMI with patients having LAGB and LSG. Mean age and preoperative BMI for LAGBP cohort were 42.5±11.6 years and 47.7±6.5 kg/m2, respectively. Mean operative time and estimated blood loss were 72±16 minutes and 23±23 mL, respectively, compared to 49±16 minutes (P=.002) and 15±23 mL for LAGB, and 66±18 minutes and 36±22 mL for LSG. There were no perioperative deaths. Hospital length of stay was 1.1±.3 days for LAGBP, versus .7±.3 days (P=.004) for LAGB, and 2.7±1.4 days (P<.001) for LSG. At 12-month follow-up, patients in the LAGBP and LAGB groups had undergone similar number of band adjustments (4.7 versus 5.1; P=.68). The %EWL was 46.1±14.8% for the LAGBP cohort, compared to 38.9±20.6% for LAGB, and 57.7±16% for LSG.

CONCLUSION

LAGBP is technically feasible and safe, and offers weight loss results positioned between LAGB and LSG at 1 year. To date, this is the largest U.S. series to compare this novel technique to more traditional weight loss procedures.

摘要

背景

腹腔镜可调节胃束带折叠术(LAGBP)是一种用于减肥手术的新技术。本研究评估了LAGBP在美国人群中的安全性和短期疗效。研究地点为美国的一家学术医疗中心。

方法

对2012年至2013年间接受LAGBP手术的患者进行回顾性分析。分析人口统计学特征、术前和围手术期详细情况、体重指数(BMI)以及超重减轻百分比(%EWL),并与同期接受腹腔镜可调节胃束带术(LAGB)或腹腔镜袖状胃切除术(LSG)的病例匹配队列进行比较。

结果

在研究期间,17例患者(14例女性)接受了LAGBP手术,并根据年龄、性别、种族和术前BMI与接受LAGB和LSG手术的患者进行病例匹配。LAGBP队列的平均年龄和术前BMI分别为42.5±11.6岁和47.7±6.5kg/m²。LAGBP的平均手术时间和估计失血量分别为72±16分钟和23±23毫升,而LAGB分别为49±16分钟(P = 0.002)和15±23毫升,LSG分别为66±18分钟和36±22毫升。围手术期无死亡病例。LAGBP的住院时间为1.1±0.3天,LAGB为0.7±0.3天(P = 0.004),LSG为2.7±1.4天(P<0.001)。在12个月的随访中,LAGBP组和LAGB组的患者进行束带调整的次数相似(4.7次对5.1次;P = 0.68)。LAGBP队列的%EWL为46.1±14.8%,LAGB为38.9±20.6%,LSG为57.7±16%。

结论

LAGBP在技术上可行且安全,在1年时的减肥效果介于LAGB和LSG之间。迄今为止,这是将这种新技术与更传统的减肥手术进行比较的最大规模的美国系列研究。

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