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采用MIDBAND(胃-胃缝合.非胃-胃缝合)进行可调节胃束带术的前瞻性、双中心、1年结果

Prospective, double center, 1-year results of adjustable gastric banding with MIDBAND (gastro-gastric suture . non-gastro-gastric suture).

作者信息

Han Sang-Moon, Kim Seong Min

机构信息

Department of Surgery, Gangnam CHA Medical Center, CHA University School of Medicine, Seoul, Korea.

Department of Surgery, Gachon University Gil Hospital, Gachon University of Medicine and Science, Incheon, Korea.

出版信息

Ann Surg Treat Res. 2017 Jun;92(6):419-422. doi: 10.4174/astr.2017.92.6.419. Epub 2017 May 29.

Abstract

PURPOSE

Although laparoscopic adjustable gastric banding (LAGB) is a popular bariatric procedure, few comprehensive studies have been investigated on the use of non-gastro-gastric sutures (NGGSs) for decreasing postoperative complications. This study aimed to assess and compare the safety and effectiveness of MIDBAND with or without gastro-gastric sutures (GGSs).

METHODS

Between February 2013 and March 2014, 41 severely obese patients underwent primary LAGB using pars flaccid technique at double center in South Korea. Excess weight loss, operative time and postoperative complications were assessed and compared between a GGS group (group 1) and a NGGS group (group 2), and patients were followed monthly for 1 year.

RESULTS

Mean body mass indices in groups 1 and 2 were 38.4 ± 4.7 and 38.9 ± 5.0 kg/m, respectively, and mean percentage excess weight losses (%EWLs) were 59.9% ± 28.4% and 50.9% ± 20.0%, respectively, at 6 months, and 75.8% ± 26.6% and 72.5% ± 27.5%, respectively, at 12 months, and these intergroup differences of %EWL were not significant (P = 0.256 and P = 0.704, respectively). Mean operative time (57.2 minutes) was shorter in group 2 than in group 1 (79.2 minutes) (P < 0.001). In terms of complications, pouch dilatation rates were similar in the 2 groups, and no case of gastric band erosion was encountered.

CONCLUSION

Operative time was shorter in the NGGS group, and pouch dilatation rates and %EWL were similar in the 2 groups. We conclude NGGS using MIDBAND is both straightforward and effective. A long-term prospective comparative study is needed to demonstrate the safety and efficacy of NGGS.

摘要

目的

尽管腹腔镜可调节胃束带术(LAGB)是一种流行的减肥手术,但关于使用非胃胃缝合线(NGGSs)来减少术后并发症的综合研究较少。本研究旨在评估和比较使用或不使用胃胃缝合线(GGSs)的MIDBAND的安全性和有效性。

方法

2013年2月至2014年3月期间,41例重度肥胖患者在韩国的双中心采用松弛部技术接受了初次LAGB手术。对GGS组(第1组)和NGGS组(第2组)的体重减轻、手术时间和术后并发症进行了评估和比较,并对患者进行了为期1年的每月随访。

结果

第1组和第2组的平均体重指数分别为38.4±4.7和38.9±5.0kg/m²,6个月时平均超重体重减轻百分比(%EWLs)分别为59.9%±28.4%和50.9%±20.0%,12个月时分别为75.8%±26.6%和72.5%±27.5%,这些组间%EWL差异无统计学意义(分别为P = 0.256和P = 0.704)。第2组的平均手术时间(57.2分钟)比第1组(79.2分钟)短(P < 0.001)。在并发症方面,两组的胃袋扩张率相似,未遇到胃束带侵蚀病例。

结论

NGGS组的手术时间较短,两组的胃袋扩张率和%EWL相似。我们得出结论,使用MIDBAND的NGGS既简单又有效。需要进行长期前瞻性比较研究以证明NGGS的安全性和有效性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/53f8/5453874/b838c95df3c2/astr-92-419-g001.jpg

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