Hunter Mehaffey J, Turrentine Florence E, Miller Michael S, Schirmer Bruce D, Hallowell Peter T
Department of Surgery, University of Virginia, Charlottesville, Virginia.
Department of Surgery, University of Virginia, Charlottesville, Virginia.
Surg Obes Relat Dis. 2016 May;12(4):778-782. doi: 10.1016/j.soard.2015.11.012. Epub 2015 Dec 1.
The long-term durability of Roux-en-Y gastric bypass (RYGB) remains ill-defined in the American population secondary to poor follow-up after bariatric surgery.
This study evaluated the population lost to follow-up to better define the long-term durability of RYGB for weight loss and co-morbidity amelioration.
All patients (n = 1087) undergoing RYGB at a single institution between 1985 and 2004 were evaluated. Univariate differences in preoperative co-morbidities, postoperative complications, annual weight loss, and 10-year co-morbidities were analyzed to compare outcomes between patients with routine follow-up and those without. Using electronic medical record review for all encounters at our academic medical center and telephone survey, we obtained data for patients lost to follow-up.
Among 1087 RYGB patients, 151 (14%) had consistent 10-year follow-up in our prospectively collected database, with yearly clinic visits beyond 2 years postoperatively. Electronic medical record review and telephone survey data were collected on an additional 500 (46%) patients, resulting in 60% of patients having 10-year follow-up after RYGB. There was no statistical difference in any preoperative or postoperative variables between the 2 groups. We found no difference in co-morbidity prevalence preoperatively or at 10 years between groups. Examination of percent excess body mass index lost at yearly intervals revealed no difference between the groups at each interval up to 10 years (P = .36).
We found no difference in 10-year outcomes, including weight loss and co-morbidity reduction, between patients with routine clinic visits and those lost to follow-up. These 10-year data address the gap in knowledge resulting from poor long-term follow-up after bariatric surgery.
由于减重手术后随访不佳,Roux-en-Y胃旁路术(RYGB)在美国人群中的长期耐久性仍不明确。
本研究评估失访人群,以更好地明确RYGB在减重及改善合并症方面的长期耐久性。
对1985年至2004年间在单一机构接受RYGB手术的所有患者(n = 1087)进行评估。分析术前合并症、术后并发症、年度体重减轻情况及10年合并症的单变量差异,以比较常规随访患者与未随访患者的结局。通过回顾我们学术医疗中心所有就诊的电子病历及电话调查,我们获取了失访患者的数据。
在1087例RYGB患者中,151例(14%)在我们前瞻性收集的数据库中有连续10年的随访,术后2年以上每年门诊就诊。另外500例(46%)患者收集了电子病历回顾和电话调查数据,使得60%的患者在RYGB术后有10年随访。两组术前或术后任何变量均无统计学差异。我们发现两组术前或10年时合并症患病率无差异。按年间隔检查体重指数超量丢失百分比发现,直至10年时每组各间隔之间无差异(P = 0.36)。
我们发现常规门诊就诊患者与失访患者在10年结局(包括体重减轻和合并症减少)方面无差异。这些10年数据填补了减重手术后长期随访不佳导致的知识空白。