AlWadaani Hamed A, Qadeer Abdul
Dr. Hamed A. AlWadaani, PhD. Department of Surgery, King Faisal University College of Medicine, Al-Ahsa 31982, Kingdom of Saudi Arabia.
Dr. Abdul Qadeer, FCPS. Department of Surgery, King Faisal University College of Medicine, Al-Ahsa 31982, Kingdom of Saudi Arabia.
Pak J Med Sci. 2017 May-Jun;33(3):524-528. doi: 10.12669/pjms.333.12874.
To find out effectiveness of revisional laparoscopic sleeve gastrectomy (RLSG) in the patients who had laparoscopic adjustable gastric banding (LAGB) and failed to reduce or regained the weight and effectiveness of sweet abstaining and exercise on postoperative weight loss.
This retrospective observational study was conducted at AlMoosa Hospital, Al-Ahsa, Kingdom of Saudi Arabia from December 2011 to November 2016. The patients who failed to reduce, regained the weight or had complications after LAGB, were performed RLSG. They were followed-up at three, six, twelve and twenty-four months intervals. Their weight, percent excess weight loss (%EWL) and body mass index (BMI) at pre-RLSG were compared with post-RLSG. The data was recorded in SPSS 22 and analyzed.
Thirty-six patients with male/female ratio of 1:5 underwent RLSG. Twelve (33.3%) were frequent sweet-eaters and twenty-four (66.7%) were not. Fourteen (38.88%) did not have exercise, while twenty-two (61.11%) had daily regular exercise. Their mean pre-RLSG weight, percent excess weight loss (%EWL)and BMI were compared with post-RLSG at the period of three, six, twelve and twenty-four months. Their mean weight reduced from 111.69 kilograms to 96.94, 87.25, 79.56 and 76.11 kilograms respectively. Their mean of the percent excess weight loss (%EWL) reduced to 22.08, 45.75, 59.64 and 66.42 kilograms respectively. Their mean pre-RLSG BMI was 43.50 kg.m, which reduced to the mean of 37.79, 34.02, 30.97 and 29.70 respectively. There were no post-operative complications in thirty (83.3%), mild like wound infection and seroma in four (11.1%) and bleeding in two (5.6%) patients. None of the patients had leakage. The patients who kept themselves abstained from sweet consumption and performed regular postoperative exercise had better results. They also had considerable reduction in appetite after RLSG.
RLSG is an effective procedure after failed LAGB in terms of weight loss having minimal rate of complications. Moreover, abstaining from sweet consumption and continuing exercise postoperatively has better results.
探讨翻修性腹腔镜袖状胃切除术（RLSG）对接受过腹腔镜可调节胃束带术（LAGB）但体重未减轻或体重反弹患者的有效性，以及戒糖和运动对术后体重减轻的有效性。
本回顾性观察研究于2011年12月至2016年11月在沙特阿拉伯王国艾哈萨的阿尔穆萨医院进行。对LAGB术后体重未减轻、体重反弹或出现并发症的患者实施RLSG。分别在术后3个月、6个月、12个月和24个月进行随访。比较患者RLSG术前和术后的体重、超重体重减轻百分比（%EWL）和体重指数（BMI）。数据记录在SPSS 22软件中并进行分析。
36例患者接受了RLSG，男女比例为1:5。其中12例（33.3%）经常食用甜食，24例（66.7%）不常食用。14例（38.88%）不运动，22例（61.11%）每天有规律运动。比较他们RLSG术前的平均体重、超重体重减轻百分比（%EWL）和BMI与术后3个月、6个月、12个月和24个月时的情况。他们的平均体重分别从111.69千克降至96.94千克、87.25千克、79.56千克和76.11千克。他们的超重体重减轻百分比（%EWL）平均值分别降至22.08%、45.75%、59.64%和66.42%。他们术前的平均BMI为43.50kg/m²，分别降至37.79、34.02、30.97和29.70。30例（83.3%）无术后并发症，4例（11.1%）有轻度并发症，如伤口感染和血清肿，2例（5.6%）出血。无患者发生渗漏。术后戒糖并定期运动的患者效果更好。RLSG术后他们的食欲也有显著下降。
就体重减轻而言，RLSG是LAGB失败后一种有效的手术方法，并发症发生率极低。此外，术后戒糖并持续运动效果更佳。
