Mortensen P B, Balslev I
Ugeskr Laeger. 1989 Nov 20;151(47):3160-3.
Twenty-three patients with a mean preoperative weight of 126 kg (100-163) and a mean preoperative Broca index of 1.89 (1.54-2.47) were submitted to gastric banding on account of severe obesity. The operative procedure, complications and results are described. The mean period of observation was 12 months (3/4-42). The mean weight loss after 12 months was 28.5 kg. The greatest weight loss per unit of time occurred during the first six months. In the majority of patients, the weight became stabilized after 12-24 months. Two patients did not lose weight and these were regarded as treatment failures. One patient died three weeks after the primary operation on account of infectious complications of pouch-perforation. Apart from this, no serious complications occurred. The incidence of wound infection was 17%, development of herniae in the scars occurred in 35% and transient symptoms of functional stenosis were encountered in 35%. Despite the high incidence of less serious complications, the authors consider that gastric banding is an employable alternative to intestinal and gastric bypass operations. In future, we will consider perioperative antibiotic therapy although gastric banding is, in principle, a clean operation. In addition, we will reserve gastric banding for patients who do not consume the majority of their calories in fluid form.
23例重度肥胖患者接受了胃束带手术，术前平均体重126kg（100 - 163kg），术前平均布罗卡指数为1.89（1.54 - 2.47）。描述了手术过程、并发症及结果。平均观察期为12个月（3/4 - 42个月）。12个月后的平均体重减轻为28.5kg。单位时间内体重减轻最多的是在前六个月。大多数患者在12 - 24个月后体重趋于稳定。两名患者体重未减轻，被视为治疗失败。一名患者在初次手术后三周因袋穿孔感染并发症死亡。除此之外，未发生严重并发症。伤口感染发生率为17%，瘢痕处疝形成发生率为35%，功能性狭窄的短暂症状发生率为35%。尽管不太严重的并发症发生率较高，但作者认为胃束带手术是肠道和胃旁路手术的一种可行替代方法。未来，尽管胃束带手术原则上是一种清洁手术，但我们将考虑围手术期抗生素治疗。此外，我们将把胃束带手术保留给不以液体形式摄入大部分热量的患者。
