Stroh Christine, Weiner R, Wolff S, Lerche C, Knoll C, Keller Th, Bruns C, Manger Th
Department of General, Abdominal and Pediatric Surgery, SRH Municipal Hospital Gera, Straße des Friedens 122, 07548, Gera, Germany,
Obes Surg. 2015 May;25(5):755-62. doi: 10.1007/s11695-014-1527-0.
Bariatric surgery outcomes have been examined in Germany since January 1, 2005. All data were registered prospectively in cooperation with the Institute of Quality Assurance in Surgery at the Otto-von-Guericke University Magdeburg.
The data were collected from an online data bank. Data collection began in 2005 for gastric banding (GB) and Roux-en-Y gastric bypass (RYGB) results. In addition to primary bariatric operations, data regarding the complications of revision procedures and redo operations were analyzed. Participation in the quality assurance study was required for all certified centers in Germany.
RYGBs are a popular redo operation after failed gastric banding. In the German Bariatric Surgery Registry (GBSR), we analyzed data from 263 RYGB operations that used a one-step approach after GB and 116 operations that used a two-step approach. The leakage rates for primary RYGB decreased to 1.8%. The incidence of leakage after a one-step RYGB after GB was lower (1.9%) than after the two-step procedure (2.6%).
RYGBs are popular procedures after failed GB in Germany. The multivariable analysis for overall intraoperative complications revealed a significant difference between the two-step and the one-step procedure. In an unadjusted and multivariate assessment, the one-step procedure had statistically lower general postoperative complications than the two-step approach. Therefore, we suggest performing band removal and RYGB as a one-step procedure. Further analysis is necessary to evaluate the risk factors for the one-step procedure. Follow-up investigations must be performed to determine whether RYGB is an effective and safe option after GB.
自2005年1月1日起，德国对减肥手术的结果进行了研究。所有数据均与马格德堡奥托 - 冯 - 格里克大学外科质量保证研究所合作进行前瞻性登记。
数据从在线数据库收集。2005年开始收集胃束带术（GB）和Roux-en-Y胃旁路术（RYGB）的结果。除了初次减肥手术外，还分析了翻修手术和再次手术并发症的数据。德国所有认证中心都必须参与质量保证研究。
RYGB是胃束带术失败后常用的再次手术。在德国减肥手术登记处（GBSR），我们分析了263例GB术后采用一步法的RYGB手术和116例采用两步法的手术数据。初次RYGB的渗漏率降至1.8%。GB术后一步法RYGB的渗漏发生率（1.9%）低于两步法（2.6%）。
在德国，RYGB是GB失败后常用的手术。对总体术中并发症的多变量分析显示，两步法和一步法之间存在显著差异。在未经调整和多变量评估中，一步法术后总体并发症在统计学上低于两步法。因此，我们建议将胃束带拆除和RYGB作为一步手术进行。有必要进一步分析以评估一步法的危险因素。必须进行随访调查以确定RYGB在GB术后是否是一种有效且安全的选择。
