Rasera I, Coelho T H, Ravelli M N, Oliveira M R M, Leite C V S, Naresse L E, Henry M A C A
Department of Surgery and Orthopedics, Botucatu Medical School-UNESP, Av. Brasil, 1034, 13416-530, Piracicaba, S.P, Brazil.
Piracicaba Bariatric Clinic/SP, Piracicaba, Brazil.
Obes Surg. 2016 Apr;26(4):762-8. doi: 10.1007/s11695-015-1851-z.
Currently, Roux-en-Y gastric bypass (RYGB) is one of the most widely used bariatric surgeries. Banding the pouch forms a banded gastric bypass operation, an accepted and frequently used variant. Placing a silastic ring around the pouch to band the gastric bypass operation increases the restriction mechanism. However, the ubiquitous use of the banded gastric bypass remains controversial. One of the controversies is the effect of the silastic ring on patients' perception of their well being after surgery because of the frequency of vomiting. A prospective, blindly randomized, comparative trial was undertaken to resolve this controversy.
Four hundred subjects scheduled for gastric bypass surgery were randomized into two arms of the trial, 200 with a silastic ring (WR) and 200 without (NR). After 2-year follow-up, the variables associated with the scores of Bariatric Analysis and Reporting Outcome System (BAROS) were analyzed.
The initial median weight (125 kg), BMI (47), and age (36 years) were the same in both the NR and WR groups. The median excess weight loss, weight regain, and incidence of vomiting were 71, 10.5, and 7.75%, respectively, in the NR group vs. 75.4 and 1.1, and 24.4% in the WR group. The mean QOL score was 79% in the NR group vs. 80% in the WR group.
After 2-year follow-up, silastic ring placement in the RYGB resulted in greater weight loss and weight stability and a threefold greater incidence of vomiting. There was no difference in the scores in the quality of life analysis.
目前，Roux-en-Y胃旁路术（RYGB）是应用最广泛的减肥手术之一。用束带环绕胃囊形成束带式胃旁路手术，这是一种被认可且常用的术式变体。在胃囊周围放置硅橡胶环进行胃旁路手术可增强限制机制。然而，束带式胃旁路术的广泛应用仍存在争议。争议之一是硅橡胶环对患者术后幸福感认知的影响，因为呕吐较为频繁。为此开展了一项前瞻性、随机双盲对照试验以解决这一争议。
400例计划接受胃旁路手术的受试者被随机分为试验的两组，200例使用硅橡胶环（WR组），200例不使用（NR组）。经过2年随访，分析与减肥分析及报告结果系统（BAROS）评分相关的变量。
NR组和WR组的初始体重中位数（125千克）、体重指数（47）和年龄（36岁）相同。NR组的多余体重减轻中位数、体重反弹和呕吐发生率分别为71%、10.5%和7.75%，而WR组分别为75.4%、1.1%和24.4%。NR组的生活质量平均评分为79%，WR组为80%。
经过2年随访，RYGB手术中放置硅橡胶环导致体重减轻更多且体重更稳定，但呕吐发生率增加了两倍。生活质量分析的评分没有差异。
