Van Looveren Ruth, Mandeville Yannick, Logghe Pieter, Vandendriessche Katrien, Verbeke Xander, Vuylsteke Patrick, Pattyn Paul, Smet Bart
UZ Leuven, Leuven, Belgium.
KU Leuven, Ambachtsstraat 52, 2390, Malle, Belgium.
Obes Surg. 2018 Mar;28(3):665-670. doi: 10.1007/s11695-017-2906-0.
Dumping is currently seen as a negative side effect of Roux-en-Y gastric bypass (RYGB). However, it may help patients to comply with their prescribed diet. In this study, we assess the role of dumping on weight loss in patients who have undergone conversion of failed restrictive surgery into RYGB.
An analysis was performed of 100 consecutive patients who underwent revisional RYGB (rRYGB) between 2006 and 2011 due to inadequate weight loss or band intolerance after laparoscopic adjustable gastric banding (LAGB). The percentage of excess weight loss (%EWL) was used to evaluate weight reduction. The Sigstad clinical diagnostic index was used to detect dumping symptoms.
Fifty-five patients (59.1%) suffered from dumping. Overall, dumpers showed a greater %EWL than non-dumpers (83.8 ± 48.0 vs 66.9 ± 44.1%, respectively, p = 0.0725). When rRYGB was performed because of inadequate weight loss following LAGB, dumping played a crucial role in weight loss (88.0 ± 21.2 vs 68.9 ± 34.5%, p = 0.0137). This effect positively correlates to post-LAGB body mass index (BMI) with a statistically significant result at BMI > 35 kg/m (82.4 ± 15.7 vs 58.4 ± 32.4%, p = 0.00341). A regression analysis of the Sigstad dumping score and %EWL shows that dumping tends to increase the %EWL.
This study provides new insights into the effect of dumping on weight loss in patients who underwent conversion of failed restrictive surgery into RYGB. Based on the findings in our patient group, we suggest that dumping helps patients achieve sustainable weight loss. Therefore, dumping can be regarded as a positive side effect rather than a complication.
目前，倾倒综合征被视为Roux-en-Y胃旁路术（RYGB）的一种负面副作用。然而，它可能有助于患者遵守规定的饮食。在本研究中，我们评估了倾倒综合征在将失败的限制性手术转换为RYGB的患者体重减轻中的作用。
对2006年至2011年间因腹腔镜可调节胃束带术（LAGB）后体重减轻不足或束带不耐受而接受修订RYGB（rRYGB）的100例连续患者进行分析。采用超重减轻百分比（%EWL）来评估体重减轻情况。使用西格斯塔德临床诊断指数来检测倾倒综合征症状。
55例患者（59.1%）出现倾倒综合征。总体而言，出现倾倒综合征的患者比未出现的患者有更高的%EWL（分别为83.8±48.0%和66.9±44.1%，p=0.0725）。当因LAGB后体重减轻不足而进行rRYGB时，倾倒综合征在体重减轻中起关键作用（88.0±21.2%对68.9±34.5%，p=0.0137）。这种效应与LAGB后的体重指数（BMI）呈正相关，在BMI>35kg/m²时有统计学显著结果（82.4±15.7%对58.4±32.4%，p=0.00341）。对西格斯塔德倾倒评分和%EWL的回归分析表明，倾倒综合征倾向于增加%EWL。
本研究为倾倒综合征在将失败的限制性手术转换为RYGB的患者体重减轻中的作用提供了新的见解。基于我们患者组的研究结果，我们认为倾倒综合征有助于患者实现可持续的体重减轻。因此，可以将倾倒综合征视为一种积极的副作用而非并发症。
