Barreto Savio George, Chisholm Jacob, Schloithe Ann, Collins Jane, Kow Lilian
Hepatobiliary and Oesophagogastric Unit, Division of Surgery and Perioperative Medicine, Flinders Medical Centre, Bedford Park, Adelaide, South Australia, Australia.
School of Medicine, Faculty of Medicine, Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia.
Obes Surg. 2018 Feb;28(2):520-525. doi: 10.1007/s11695-017-2889-x.
The purpose of this study is to determine whether the reason for gastric band explantation would influence percentage excess weight loss (%EWL) following revisional Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG).
MATERIALS & METHODS: This is a retrospective cohort study, whose data are maintained in a prospective surgical database. The study period was from January 2012 to March 2017. Revisional surgeries were performed in a two-step manner, namely, first surgery LAGB explantation and second surgery (RYGB or SG). Two-way between-groups analysis of variance was used to examine effects of reason for band explantation (failed versus complication) and type of revisional surgery (RYGB versus SG) on %EWL at 10 months, 1 and 2 years.
Cohort included 171 patients-146 women (85.4%) and 25 men, median age 51 years (range 22-76). Band-related complications accounted for 55% of explantations. Overall, 95 patients (56%) underwent a revisional RYGB, and 76 patients underwent a revisional SG. There was no difference in age or gender in terms of reason for band explantation or choice of revisional surgery. There was no difference in morbidity between the two groups (SG 2.6% versus RYGB 4.2%; p = .464). Patients undergoing revisional RYGB for failed weight loss had a significantly lower %EWL at 2 years compared to patients undergoing an SG for failed weight loss (p = .014) or an RYGB for band-related complications (p = .021).
Patients undergoing revisional RYGB following band explantation for failed weight loss have a significantly lower %EWL at 2 years compared to patients undergoing an SG for failed weight loss or an RYGB for band-related complications.
本研究旨在确定胃束带取出术的原因是否会影响翻修性 Roux-en-Y 胃旁路术（RYGB）或袖状胃切除术（SG）后的超重体重减轻百分比（%EWL）。
这是一项回顾性队列研究，其数据保存在前瞻性手术数据库中。研究期间为 2012 年 1 月至 2017 年 3 月。翻修手术分两步进行，即第一次手术为胃束带取出术，第二次手术为（RYGB 或 SG）。采用双向组间方差分析来检验束带取出术的原因（失败与并发症）和翻修手术类型（RYGB 与 SG）对 10 个月、1 年和 2 年时%EWL 的影响。
队列包括 171 例患者，其中 146 例女性（85.4%）和 25 例男性，中位年龄 51 岁（范围 22 - 76 岁）。与束带相关的并发症占取出术的 55%。总体而言，95 例患者（56%）接受了翻修性 RYGB，76 例患者接受了翻修性 SG。在束带取出术的原因或翻修手术的选择方面，年龄或性别没有差异。两组之间的发病率没有差异（SG 为 2.6%，RYGB 为 4.2%；p = 0.464）。与因减肥失败而接受 SG 手术的患者（p = 0.014）或因束带相关并发症而接受 RYGB 手术的患者（p = 0.021）相比，因减肥失败而接受翻修性 RYGB 手术的患者在 2 年时的%EWL 显著更低。
与因减肥失败而接受 SG 手术的患者或因束带相关并发症而接受 RYGB 手术的患者相比，因减肥失败而在胃束带取出术后接受翻修性 RYGB 手术的患者在 2 年时的%EWL 显著更低。
