Papadimitriou Georgios, Vardas Konstantinos, Alfaras Konstantinos, Alfaras Panagiotis
First Department of Surgery and Transplant Unit, Evangelismos General Hospital, Athens, Greece.
JSLS. 2015 Jan-Mar;19(1):e2013.00363. doi: 10.4293/JSLS.2013.00363.
Laparoscopic adjustable gastric banding has become the most popular procedure for the treatment of morbid obesity in Europe. The objectives of this series are to report the results of the 4-year experience of a single surgeon and to define the learning curve.
A retrospective review of 156 patients who underwent laparoscopic adjustable gastric banding between October 2006 and May 2010 was performed. Patients were separated into 3 groups: group 1 comprised the first 50 patients; group 2 comprised the second 50 patients; and group 3 comprised the last group of patients, with a total of 56 patients.
The male-to-female ratio was 1:4 (33 male and 133 female patients). The mean age was 38 years (range, 17-62 years). The mean preoperative body mass index was 44.9 kg/m(2). The mean percent excess weight loss was 41.7% at the 1-year follow-up visit (153 patients, 98%), 49.7% at the 2-year follow-up visit (147 patients, 94%), and 50.2% at the 3-year follow-up visit (127 patients, 81%). The overall complication rate and major complication rate were 15.4% and 3.2%, respectively. There were no deaths. Percent excess weight loss, length of hospitalization (in days), and complication rates were compared among the 3 groups. No significant differences were noted among the groups except in the number of complications (P < .001), but all data were clearly improved in groups 2 and 3.
The analyses in this study have documented one more time that laparoscopic adjustable gastric banding is an effective procedure for the treatment of morbid obesity, achieving >50% excess weight loss at 3 years. It is a procedure with certain complications even when performed by a surgeon with previous experience in laparoscopic surgery. According to our subset analysis, the learning curve is at least 50 procedures.
腹腔镜可调节胃束带术已成为欧洲治疗病态肥胖最常用的手术方法。本系列研究的目的是报告一位外科医生4年的手术经验结果，并确定学习曲线。
对2006年10月至2010年5月期间接受腹腔镜可调节胃束带术的156例患者进行回顾性研究。患者分为3组：第1组包括前50例患者；第2组包括接下来的50例患者；第3组包括最后一组患者，共56例。
男女比例为1:4（男性33例，女性133例）。平均年龄为38岁（范围17 - 62岁）。术前平均体重指数为44.9 kg/m²。1年随访时（153例患者，98%）平均超重体重减轻百分比为41.7%，2年随访时（147例患者，94%）为49.7%，3年随访时（127例患者，81%）为50.2%。总体并发症发生率和主要并发症发生率分别为15.4%和3.2%。无死亡病例。对3组患者的超重体重减轻百分比、住院天数和并发症发生率进行比较。除并发症数量外（P <.001），各组间未发现显著差异，但第2组和第3组的所有数据均有明显改善。
本研究分析再次证明，腹腔镜可调节胃束带术是治疗病态肥胖的有效方法，3年时超重体重减轻超过50%。即使由有腹腔镜手术经验的外科医生进行该手术，也会出现一定的并发症。根据我们的亚组分析，学习曲线至少为50例手术。
