Moon Rena C, Frommelt Ashley, Teixeira Andre F, Jawad Muhammad A
Department of Bariatric Surgery, Orlando Regional Medical Center, Orlando Health, 89 Copeland Dr, 1st Floor, Orlando, FL, USA.
Obes Surg. 2018 Jan;28(1):212-217. doi: 10.1007/s11695-017-2832-1.
Variations have been proposed in order to improve weight loss and decrease complication profiles in Roux-en-Y gastric bypass (RYGB) patients. We previously reported a preliminary result of pericardial patch ring RYGB. We aim to report a detailed result of banded RYGB by comparing these patients to non-banded RYGB patients with larger case number and longer follow-up.
A retrospective chart review was performed in 543 banded RYGB and 607 non-banded RYGB patients who underwent laparoscopic RYGB between January 2009 and December 2014.
Thirty-day readmission rate was 3.1% (n = 16) in the banded group and 3.8% (n = 23) in the non-banded group. Thirty-day reoperation rate was 1.5% (n = 8) in the banded group and 1.6% (n = 10) in the non-banded group. Two mortalities occurred after a mesenteric venous thrombosis and an intracranial hemorrhage in the non-banded group. The differences in 30-day readmission and reoperation rates were not statistically significant between the two groups. Mean percentage of excess BMI loss (%EBMIL) dating from the time of RYGB was 53.1, 72.5, 76.5, 78.8, and 73.3% in the banded group, and 51.5, 73.5, 78.8, 79.0, and 74.8% in the non-banded group at 6, 12, 18, 24, and 36 months, respectively, adjusted for preoperative BMI. The differences in %EBMIL were not significant at any follow-up points between the two groups.
Banded laparoscopic RYGB with a pericardial patch may not demonstrate a significant additional weight loss or prevent future weight regain. We were not able to demonstrate a clear advantage of banded RYGB over non-banded RYGB.
为了改善胃旁路术（RYGB）患者的体重减轻情况并降低并发症发生率，人们提出了多种术式改良。我们之前报告了心包补片环RYGB的初步结果。我们旨在通过对比更多病例数和更长随访期的带环RYGB患者与非带环RYGB患者，报告带环RYGB的详细结果。
对2009年1月至2014年12月期间接受腹腔镜RYGB手术的543例带环RYGB患者和607例非带环RYGB患者进行回顾性病历审查。
带环组30天再入院率为3.1%（n = 16），非带环组为3.8%（n = 23）。带环组30天再次手术率为1.5%（n = 8），非带环组为1.6%（n = 10）。非带环组发生了2例死亡，分别因肠系膜静脉血栓形成和颅内出血。两组间30天再入院率和再次手术率的差异无统计学意义。以RYGB手术时间计算，调整术前BMI后，带环组在6、12、18、24和36个月时的平均超重BMI降低百分比（%EBMIL）分别为53.1%、72.5%、76.5%、78.8%和73.3%，非带环组分别为51.5%、73.5%、78.8%、79.0%和74.8%。两组在任何随访时间点的%EBMIL差异均无统计学意义。
带心包补片的腹腔镜带环RYGB可能不会显著增加体重减轻或防止未来体重反弹。我们未能证明带环RYGB相对于非带环RYGB有明显优势。
