Tammaro Pasquale, Hansel Boris, Police Andrea, Kousouri Marina, Magnan Christophe, Marmuse Jean Pierre, Arapis Konstantinos
Department of General and Digestive Surgery, University Hospital Bichat Claude Bernard, 46 rue Henri Huchard, Paris, 75877, Paris CEDEX 18, France.
Team of Diabetes Vascular Complication Cordelier Recherche Center, Department of Diabetes, Nutrition Bichat-Claude Bernard University Hospital, Paris, France.
World J Surg. 2017 Aug;41(8):2078-2086. doi: 10.1007/s00268-017-3922-x.
Weight loss and overall outcomes following laparoscopic adjustable gastric banding (LAGB) are more variable than with other bariatric procedures. Our aim was to investigate the predictive value of certain parameters in a cohort of 794 patients with 10 years' minimum follow-up after LAGB.
We retrospectively reviewed the records of 794 patients undergoing LAGB performed by the authors between April 1996 and December 2004. We collected patients' data on weight loss and band-related complications and performed logistic regression modelling and calculated Kaplan-Meier curves for band preservation.
The follow-up rate at 10 years was 90.4%. The mean follow-up duration was 15.1 years (range, 120-228 months). Overall band removal with or without conversion or replacement was required in 304 (38.2%) patients. The mean survival time of the band was 148.4 months (95% confidence interval: 138.3-167.4), and there was no difference in the rate of removal by operative technique (p = 0.7). The highest rate of band removal occurred in female patients (p = 0.05), those with BMI > 50 kg/m (p = 0.005) and in those <40 years of age (p = 0.04). For patients with the band in situ, the success rate was significantly lower in patients with initial BMI > 50 kg/m. Conversely, differences in success rate were not statistically significant for age (using 50 years as the cut-off), technique or sex.
Higher rates of removal occurred in women, younger patients and those with BMI > 50 kg/m. Regardless of these criteria, the rate of band removal for complications rose over time. Patients should be informed of the high risk of the need for band removal long-term.
与其他减肥手术相比，腹腔镜可调节胃束带术（LAGB）后的体重减轻和总体结果更具变异性。我们的目的是在一组794例接受LAGB且至少随访10年的患者中研究某些参数的预测价值。
我们回顾性分析了1996年4月至2004年12月期间作者实施LAGB手术的794例患者的记录。我们收集了患者体重减轻和束带相关并发症的数据，并进行了逻辑回归建模，计算了束带保留的Kaplan-Meier曲线。
10年随访率为90.4%。平均随访时间为15.1年（范围120 - 228个月）。304例（38.2%）患者需要进行带或不带转换或更换的整体束带移除。束带的平均存活时间为148.4个月（95%置信区间：138.3 - 167.4），手术技术导致的移除率无差异（p = 0.7）。束带移除率最高的是女性患者（p = 0.05）、BMI>50 kg/m²的患者（p = 0.005）以及年龄<40岁的患者（p = 0.04）。对于束带在位的患者，初始BMI>50 kg/m²的患者成功率显著较低。相反，年龄（以50岁为界）、技术或性别在成功率方面的差异无统计学意义。
女性、年轻患者和BMI>50 kg/m²的患者束带移除率较高。无论这些标准如何，因并发症导致的束带移除率随时间上升。应告知患者长期需要移除束带的高风险。
