Chansaenroj Pawan, Aung Lwin, Lee Wei-Jei, Chen Shu Chun, Chen Jung-Chien, Ser Kong-Han
Department of Surgery, Min-Sheng General Hospital, Taoyuan, Taiwan.
Department of Surgery, Somdech Phra Pinklao (Royal Thai Naval) Hospital, Bangkok, Thailand.
Obes Surg. 2017 Nov;27(11):2861-2867. doi: 10.1007/s11695-017-2716-4.
Laparoscopic adjustable gastric banding (LAGB) was one of the commonly performed bariatric operations; however, it carries a high revision rate. The aim of the present study was to report the long-term outcomes of LAGB and compare the outcomes between the different revision procedures.
All patients who underwent LAGB in a large bariatric center in Asia between May 2002 and April 2011 were included. Interval between primary LAGB to the revision operation, the reason and type of revision surgery were identified and analyzed.
A total of 275 consecutive patients were included. All of the procedures were completed laparoscopically with no major complications. The percentage of excess weight loss (%EWL) at 10-year follow-up was 45%. In this study, 53 patients (19.3%) had revision surgery, including with 26 single anastomosis (mini-) gastric bypass (R-LSAGB) (49%), 17 sleeve gastrectomy (R-LSG) (32.1%), 9 Roux-en-Y gastric bypass (R-LRYGB) (17%), and 1 other procedure (1.9%). A major complication occurred in 6 patients (11.3%). All of the follow-up patients with revision surgeries had %EWL > 50% at the 2-year follow-up. R-LSAGB patients achieved better weight loss than those who underwent R-LSG and R-LRYGB (p = 0.001).
The long-term result for weight loss after LAGB is unsatisfactory. The revision of failed LAGB to other bariatric surgeries is safe and can be performed in one stage with a low complication rate. Patients who underwent R-LSAGB had better weight loss results than the R-LSG or R-LRYGB patients.
腹腔镜可调节胃束带术（LAGB）是常见的减肥手术之一；然而，其翻修率很高。本研究的目的是报告LAGB的长期疗效，并比较不同翻修手术之间的疗效。
纳入2002年5月至2011年4月期间在亚洲一家大型减肥中心接受LAGB手术的所有患者。确定并分析初次LAGB手术至翻修手术的间隔时间、翻修手术的原因和类型。
共纳入275例连续患者。所有手术均通过腹腔镜完成，无重大并发症。10年随访时的超重体重减轻百分比（%EWL）为45%。在本研究中，53例患者（19.3%）接受了翻修手术，其中26例为单吻合（迷你）胃旁路术（R-LSAGB）（49%），17例为袖状胃切除术（R-LSG）（32.1%），9例为Roux-en-Y胃旁路术（R-LRYGB）（17%），1例为其他手术（1.9%）。6例患者（11.3%）发生了重大并发症。所有接受翻修手术的随访患者在2年随访时的%EWL均>50%。R-LSAGB患者的体重减轻情况优于接受R-LSG和R-LRYGB的患者（p = 0.001）。
LAGB术后的长期减肥效果并不理想。将失败的LAGB翻修为其他减肥手术是安全的，且可一期进行，并发症发生率低。接受R-LSAGB的患者比接受R-LSG或R-LRYGB的患者有更好的体重减轻效果。
