腹腔镜Roux-en-Y胃旁路术与腹腔镜可调节胃束带术治疗超级肥胖患者：围手术期及早期结果
Laparoscopic Roux-en-Y gastric bypass versus laparoscopic adjustable gastric banding in the super-obese: peri-operative and early outcomes.
作者信息
Giordano S, Tolonen P, Victorzon M
机构信息
Department of Plastic and General Surgery, Turku University Hospital, Turku, Finland Department of Gastrointestinal Surgery, Vaasa Central Hospital, Vaasa, Finland
Department of Gastrointestinal Surgery, Vaasa Central Hospital, Vaasa, Finland.
出版信息
Scand J Surg. 2015 Mar;104(1):5-9. doi: 10.1177/1457496914553148. Epub 2015 Jan 26.
INTRODUCTION
Controversy exists between laparoscopic Roux-en-Y gastric bypass and laparoscopic adjustable gastric banding in super-obese patients.
METHODS
This is a retrospective review of prospectively collected data. A total of 102 consecutive super-obese (body mass index >50) patients underwent laparoscopic Roux-en-Y gastric bypass (Group 1), and 79 consecutive ones underwent laparoscopic adjustable gastric banding (Group 2). Early complications and weight loss outcomes were evaluated.
RESULTS
No significant difference was found in operative mean (± standard deviation) time (93.5 ± 33 vs 87.7 ± 39 min, p = 0.29), hospital stay (2.68 ± 2.27 vs 2.75 ± 1.84 days, p = 0.80), or overall early postoperative morbidity (17.65% and 10.12%, p = 0.20). Intra-operative complications occurred in six patients (5.9%) in Group 1 and none in Group 2 (0.0%, p = 0.04). Mean excess weight loss percent at 6 and 12 months in Group 1 was 44.75% ± 11.84% and 54.71% ± 18.18% versus 26.20% ± 12.42% and 31.55% ± 19.79% in Group 2 (p < 0.001).
CONCLUSION
There seems to be no significant differences in early complications between laparoscopic Roux-en-Y gastric bypass and laparoscopic adjustable gastric banding operations in the short term. Weight loss and excess weight loss percent at 6 and 12 months are significantly better after laparoscopic Roux-en-Y gastric bypass.
引言
对于超级肥胖患者，腹腔镜Roux-en-Y胃旁路手术和腹腔镜可调节胃束带术之间存在争议。
方法
这是一项对前瞻性收集数据的回顾性研究。共有102例连续的超级肥胖（体重指数>50）患者接受了腹腔镜Roux-en-Y胃旁路手术（第1组），79例连续患者接受了腹腔镜可调节胃束带术（第2组）。评估早期并发症和体重减轻结果。
结果
手术平均（±标准差）时间（93.5±33对87.7±39分钟，p = 0.29）、住院时间（2.68±2.27对2.75±1.84天，p = 0.80）或总体术后早期发病率（17.65%和10.12%，p = 0.20）方面未发现显著差异。第1组有6例患者（5.9%）发生术中并发症，第2组无（0.0%，p = 0.04）。第1组在6个月和12个月时的平均超重减轻百分比分别为44.75%±11.84%和54.71%±18.18%，而第2组为26.20%±12.42%和31.55%±19.79%（p < 0.001）。
结论
短期内，腹腔镜Roux-en-Y胃旁路手术和腹腔镜可调节胃束带术在早期并发症方面似乎没有显著差异。腹腔镜Roux-en-Y胃旁路手术后6个月和12个月的体重减轻和超重减轻百分比明显更好。
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