Sugerman H J, Londrey G L, Kellum J M, Wolf L, Liszka T, Engle K M, Birkenhauer R, Starkey J V
Department of Surgery, Medical College of Virginia, Virginia Commonwealth University, Richmond 23298-0001.
Am J Surg. 1989 Jan;157(1):93-102. doi: 10.1016/0002-9610(89)90427-3.
In a previous study, Roux-Y gastric bypass was found to be significantly more effective than vertical banded gastroplasty for weight loss in morbid obesity, especially for patients addicted to sweets, probably as a result of dumping syndrome symptoms. This study evaluated the ability to selectively assign nonsweet eaters to vertical banded gastroplasty and sweet eaters to gastric bypass. Compared with random assignment, the percentage excess weight lost at 2 years improved significantly with both groups combined. In the vertical banded gastroplasty group, the percentage increased from 41 +/- 19 to 55 +/- 19 percent. With selective assignment, the percentage excess weight lost with gastric bypass was still better than that with vertical banded gastroplasty. Weight loss with gastric bypass was still superior to that of vertical banded gastroplasty but at the expense of more complications. Gastric bypass was ineffective in 19 percent of the super obese patients. A combined restrictive, malabsorptive procedure may be necessary in such persons.
在先前的一项研究中，发现Roux-Y胃旁路术在治疗病态肥胖症的减重效果上显著优于垂直束带胃成形术，尤其是对于嗜甜患者，这可能是倾倒综合征症状所致。本研究评估了将非嗜甜者分配至垂直束带胃成形术、嗜甜者分配至胃旁路术的能力。与随机分配相比，两组合并后2年时的超重减轻百分比有显著改善。在垂直束带胃成形术组，该百分比从41±19%增至55±19%。通过选择性分配，胃旁路术的超重减轻百分比仍优于垂直束带胃成形术。胃旁路术的减重效果仍优于垂直束带胃成形术，但代价是并发症更多。胃旁路术在19%的超级肥胖患者中无效。对于这类患者，可能需要采用限制性与吸收不良性相结合的手术。
