School of Nursing, Duquesne University, Pittsburgh, Pennsylvania.
Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania.
Surg Obes Relat Dis. 2017 Sep;13(9):1562-1571. doi: 10.1016/j.soard.2017.03.028. Epub 2017 Apr 4.
Having accurate information on bariatric surgery-related gastrointestinal (GI) symptoms is critical for patient care.
To report on surgery-related GI symptoms over the first 3 years following Roux-en-Y gastric bypass and laparoscopic adjustable gastric band.
Three academic medical centers in the United States.
As a substudy of the Longitudinal Assessment of Bariatric Surgery Consortium, 183 participants (pre-surgery median body mass index = 45.1 kg/m; median age = 46 yr; 83.1% female). completed the Eating Disorder Examination-Bariatric Surgery Version interview at≥1 annual assessment. Patients self-reported frequency of dysphagia, dumping syndrome, and spontaneous vomiting.
Prevalence of dysphagia at least once weekly decreased post-laparoscopic adjustable gastric band surgery from 43.9% (95% confidence interval [CI], 32.2-55.6) in year 1 to 27.5% (95% CI, 15.2-39.9) in year 3 (P = .02). Dysphagia and dumping at least once weekly also appeared to decrease in years 1-3 post-Roux-en-Y gastric bypass (i.e., from 16.7% [95% CI, 9.4-24.1] to 10.9% [95% CI, 4.0-17.8] and from 9.9% [95% CI, 4.3-15.5] to 6.3% [95% CI, 1.7-10.9], respectively), but power was limited to evaluate trends. Vomiting at least once weekly was rare (<6%) in years 1-3 following both procedures. Controlling for potential confounders and surgical procedure, loss of control eating at least once weekly was associated with higher risk of at least once weekly dysphagia (relative risk = 2.01, 95% CI, 1.36-2.99, P = .001).
The prevalence of bariatric surgery-related GI symptoms appears to decrease across follow-up. Symptoms were associated with loss of control eating, suggesting a target for clinical intervention.
准确了解减重手术相关的胃肠道（GI）症状对患者护理至关重要。
报告罗伊恩-耶（Roux-en-Y）胃旁路术和腹腔镜可调节胃束带术（laparoscopic adjustable gastric band）后 3 年内与手术相关的 GI 症状。
美国三家学术医疗中心。
作为肥胖症手术纵向评估联盟的子研究，183 名参与者（术前中位数身体质量指数=45.1kg/m；中位数年龄=46 岁；83.1%为女性）在≥1 次年度评估时完成了饮食失调检查-减重手术版（Eating Disorder Examination-Bariatric Surgery Version）访谈。患者自我报告吞咽困难、倾倒综合征和自发性呕吐的频率。
腹腔镜可调节胃束带手术后，每周至少出现一次吞咽困难的患病率从第 1 年的 43.9%（95%置信区间[CI]，32.2-55.6）下降到第 3 年的 27.5%（95%CI，15.2-39.9）（P=0.02）。罗伊恩-耶胃旁路手术后，1-3 年内也似乎减少了每周至少一次出现的吞咽困难和倾倒（即，从 16.7%[95%CI，9.4-24.1]降至 10.9%[95%CI，4.0-17.8]，从 9.9%[95%CI，4.3-15.5]降至 6.3%[95%CI，1.7-10.9]），但评估趋势的能力有限。两种手术后每周至少呕吐一次的情况均较为少见（<6%）。在控制潜在混杂因素和手术程序后，每周至少一次出现失控性进食与每周至少一次出现吞咽困难的风险增加相关（相对风险=2.01，95%CI，1.36-2.99，P=0.001）。
减重手术相关的 GI 症状的患病率似乎在随访过程中有所下降。症状与失控性进食有关，提示这是临床干预的目标。
