Khoraki Jad, Moraes Marilia G, Neto Adriana P F, Funk Luke M, Greenberg Jacob A, Campos Guilherme M
Division of General Surgery, Department of Surgery, University of Wisconsin, Madison, WI, United States; Division of Bariatric and Gastrointestinal Surgery, Department of Surgery, Virginia Commonwealth University, Richmond, VA, United States.
Division of General Surgery, Department of Surgery, University of Wisconsin, Madison, WI, United States.
Am J Surg. 2018 Jan;215(1):97-103. doi: 10.1016/j.amjsurg.2017.06.027. Epub 2017 Jul 3.
Laparoscopic adjustable gastric banding (LAGB) is an option for the treatment of severe obesity. Few US studies have reported long-term outcomes. We aimed to present long-term outcomes with LAGB.
Retrospective study of patients who underwent LAGB at an academic medical center in the US from 1/2005 to 2/2012. Outcomes included weight loss, complications, re-operations, and LAGB failure.
208 patients underwent LAGB. Mean BMI was 45.4 ± 6.4 kg/m. Mean follow-up was 5.6 (0.5-10.7) years. Complete follow-up was available for 90% at one year (186/207), 80% at five years (136/171), and 71% at ten years (10/14). Percentage of excess weight loss at one, five, and ten years was 29.9, 30, and 16.9, respectively. Forty-eight patients (23.1%) required a reoperation. LAGB failure occurred in 118 (57%) and higher baseline BMI was the only independently associated factor (OR 1.1; 95%CI 1.0-1.1; p = 0.016).
LAGB was associated with poor short and long-term weight loss outcomes and a high failure rate. With the increased safety profile and greater efficacy of other surgical techniques, LAGB utilization should be discouraged.
腹腔镜可调节胃束带术（LAGB）是治疗重度肥胖的一种选择。美国很少有研究报告其长期疗效。我们旨在呈现LAGB的长期疗效。
对2005年1月至2012年2月在美国一家学术医疗中心接受LAGB的患者进行回顾性研究。疗效包括体重减轻、并发症、再次手术和LAGB失败情况。
208例患者接受了LAGB手术。平均体重指数（BMI）为45.4±6.4kg/m²。平均随访时间为5.6（0.5 - 10.7）年。一年时90%（186/207）、五年时80%（136/171）、十年时71%（10/14）可获得完整随访。一年、五年和十年时超重减轻的百分比分别为29.9%、30%和16.9%。48例患者（23.1%）需要再次手术。118例（57%）发生LAGB失败，较高的基线BMI是唯一独立相关因素（比值比1.1；95%置信区间1.0 - 1.1；p = 0.016）。
LAGB与短期和长期体重减轻效果不佳及高失败率相关。鉴于其他手术技术安全性提高且疗效更佳，应不鼓励使用LAGB。
