Ghosh Simon, Bui The Lan, Skinner Christine E, Tan Stephanie, Hopkins George
Royal Brisbane and Women's Hospital, Cnr Butterfield Street and Bowen Bridge Road, Herston, Queensland, 4029, Australia.
Holy Spirit Northside Private Hospital, Suite 11, Level 2, 956 Gympie Road, Chermside, Queensland, 4032, Australia.
Obes Surg. 2017 Nov;27(11):3048-3054. doi: 10.1007/s11695-017-2887-z.
In many countries, laparoscopic adjustable gastric banding (LAGB) was previously the most commonly performed bariatric procedure due to its operative safety and early efficacy. This procedure is now superseded because of doubtful long-term results and late complications. Many people eventually required revisional bariatric surgery such as conversion to single anastomosis gastric bypass (SAGB). This study aims to assess the safety and durability of single-stage conversion from LAGB to SAGB in patients who are intolerant to LAGB and who also fail to lose weight, or re-gain weight.
Seventy-four patients with BMI > 35 kg m were selected from a prospective bariatric database between July 2012 and December 2015 for revisional laparoscopic SAGB surgery and were followed up at 6 weeks, 3, 6 and 12 months after their operation.
The mean BMI at 6 weeks, then 3, 6 and 12 months were 41.6 ± 7.66, 38.8 ± 7.54, 35.4 ± 7.10 and 33.2 ± 7.34 kg m, respectively. The mean percentage EWL at 6 weeks then 3, 6 and 12 months were 21.0 ± 9.12, 37.8 ± 12.5, 55.1 ± 15.8 and 67.0 ± 19.6%, respectively. Postoperative follow-up at these times were 97, 85, 69 and 46%, respectively. Early (< 30 day) morbidity was 20.3% with major complications of CD grade 3a or more of 13.5%.
This study demonstrates that single-stage revisional SAGB after a failed LAGB achieved good short-term weight loss and low 30-day morbidity.
在许多国家，由于其手术安全性和早期疗效，腹腔镜可调节胃束带术（LAGB）曾是最常用的减肥手术。由于长期效果存疑和晚期并发症，该手术现已被取代。许多人最终需要进行减肥手术修正，如转为单吻合口胃旁路术（SAGB）。本研究旨在评估在对LAGB不耐受且减肥失败或体重反弹的患者中，从LAGB单阶段转为SAGB的安全性和持久性。
从2012年7月至2015年12月的前瞻性减肥数据库中，选取74例BMI>35 kg/m的患者进行腹腔镜SAGB修正手术，并在术后6周、3个月、6个月和12个月进行随访。
术后6周、3个月、6个月和12个月时的平均BMI分别为41.6±7.66、38.8±7.54、35.4±7.10和33.2±7.34 kg/m。术后6周、3个月、6个月和12个月时的平均额外体重减轻百分比分别为21.0±9.12、37.8±12.5、55.1±15.8和67.0±19.6%。这些时间点的术后随访率分别为97%、85%、69%和46%。早期（<30天）发病率为20.3%，3a级或更严重的主要并发症为13.5%。
本研究表明，LAGB失败后单阶段修正SAGB可实现良好的短期体重减轻，且30天发病率较低。
