Giet Leeying, Baker Julia, Favretti Franco, Segato Gianni, Super Paul, Singhal Rishi, Ashton David
1Heart of England NHS Foundation Trust, Birmingham, UK.
Healthier Weight Centres, 11 Highfield Road, B15 3DU, Birmingham, UK.
BMC Obes. 2018 Apr 12;5:12. doi: 10.1186/s40608-018-0189-1. eCollection 2018.
Laparoscopic adjustable gastric band (LAGB) has been an established bariatric procedure for the last three decades and was, for many years, the first-choice procedure for the treatment of chronic obesity. However, more recently, the popularity of the LAGB has been in sharp decline and has been replaced by other procedures such as the Roux-En-Y gastric bypass and sleeve gastrectomy. A key driver in this decline has been the high revision and early explanation rates reported in some studies.
This was a retrospective study of 2246 patients who underwent LAGB at a large private clinic in the UK between June 2004 and October 2014.
2246 patients were included in the study; 1945 (84.6%) were women. All patients were followed up for 2 years following their procedure and subsequent follow up was at the discretion of patients. Mean follow up duration was 43.7 +/- 29.3 months. Operative mortality was zero and there were no in-hospital returns to theatre. Mean preoperative weight and body mass index (BMI) were 111.2 ± 22.1 kg and 39.9 ± 6.7 kg/m respectively. Mean excess % BMI loss at 1-, 2-, 5- and 8-years of follow-up was 43.1 ± 25.4, 47.9 ± 31.9, 52.4 ± 41.7 and 57.1% ± 28.6 respectively. There was no significant difference in mean excess % BMI loss between those < 50 or ≥ 50 years old ( value = 0.23) or between patients with an initial BMI of < or ≥ 50 kg/m (p value = 0.65). Complications over nine years occurred in 130 (5.8%) patients and included: 39 (1.7%) slippage or pouch dilatation, 2 (0.04%) erosions and 76 (3.4%) problems related to the access port or LAGB tubing. The overall re-operation rate for LAGB complications was 4.2% over 9 years with a LAGB explantation rate of 1.5%. 39 LAGBs were converted to a sleeve or gastric bypass procedure, 11 of these due to complications.
This is the first study to report on LAGB outcomes from a private clinic in the UK. LAGB is a safe procedure, which delivers significant and durable weight loss with acceptable complications rates and low re-operation rate.
在过去三十年中，腹腔镜可调节胃束带术（LAGB）一直是一种成熟的减肥手术，并且多年来一直是治疗慢性肥胖症的首选手术。然而，最近，LAGB的受欢迎程度急剧下降，已被其他手术如Roux - 恩 - 胃旁路术和袖状胃切除术所取代。这种下降的一个关键驱动因素是一些研究报告的高翻修率和早期取出率。
这是一项对2004年6月至2014年10月期间在英国一家大型私人诊所接受LAGB手术的2246例患者的回顾性研究。
2246例患者纳入研究；1945例（84.6%）为女性。所有患者术后均随访2年，后续随访由患者自行决定。平均随访时间为43.7±29.3个月。手术死亡率为零，且无患者在住院期间返回手术室。术前平均体重和体重指数（BMI）分别为111.2±22.1kg和39.9±6.7kg/m²。随访1年、2年、5年和8年时，平均超重BMI丢失百分比分别为43.1±25.4%、47.9±31.9%、52.4±41.7%和57.1%±28.6%。年龄<50岁或≥50岁的患者之间（p值 = 0.23）以及初始BMI<或≥50kg/m²的患者之间，平均超重BMI丢失百分比无显著差异（p值 = 0.65）。9年期间130例（5.8%）患者出现并发症，包括：39例（1.7%）滑脱或胃囊扩张、2例（0.04%）侵蚀以及76例（3.4%）与接入端口或LAGB导管相关的问题。9年期间LAGB并发症的总体再次手术率为4.2%，LAGB取出率为1.5%。39例LAGB转换为袖状胃切除术或胃旁路术，其中11例是由于并发症。
这是第一项报告英国一家私人诊所LAGB手术结果的研究。LAGB是一种安全的手术，能实现显著且持久的体重减轻，并发症发生率可接受且再次手术率低。
