Obesity Surgery Center of Campinas (CCOC), Campinas, Brazil; Department of Surgery, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas, Brazil.
Obesity Surgery Center of Campinas (CCOC), Campinas, Brazil.
Surg Obes Relat Dis. 2018 Jul;14(7):910-917. doi: 10.1016/j.soard.2018.03.023. Epub 2018 Mar 26.
To evaluate the weight loss outcomes of banded Roux-en-Y gastric bypass (RYGB) during a 10-year follow-up.
Private health-providing service, Brazil.
A prospective study was conducted on 928 patients with obesity who underwent banded RYGB. Patients were divided into 2 groups according to their initial body mass index (BMI), morbid obesity (BMI 35-49.9 kg/m) and super obesity (BMI ≥50 kg/m). The percentages of excess weight loss (%EWL) and total weight loss (%TWL) at 18, 24, 36, 48, 60, 72, 84, 96, 108, and 120 months after surgery were assessed and compared, and the rates of surgical failure were also assessed.
There were individuals who were lost to follow-up at each year, including 423 (45.6%) at 18 months, 431 (46.4%) at 24 months, 482 (51.9%) at 36 months, 568 (61.2%) at 48 months, 658 (70.9%) at 60 months, 725 (78.1%) at 72 months, 781 (84.2%) at 84 months, 819 (88.3%) at 96 months, 838 (90.3%) at 108 months, and 819 (88.3%) at 120 months. The maximal %EWL was achieved at 18 months (P<.001). After 10 years, there was no significant change in mean BMI (28.7 ± 4.1 versus 28.5 ± 3.6 kg/m; P = .07) or %EWL (80.4 ± 19.1 versus 79.7 ± 23.4; P = .065), but the mean %TWL was significantly lower at 10 years (30.8 ± 8.5 versus 32.5 ± 8.1; P = .035) in the morbid obesity group, compared with the values observed over 5 years. In the super obesity group, the %EWL significantly decreased from 77.7 ± 16.5 kg/m at 24 months to 71.3 ± 18.1 kg/m at 72 months (P = .008); at 5 years, mean BMI (33.1 ± 5.8 kg/m) did not differ from the one observed at 10 years (36.4 ± 5 kg/m; P = .21), as well as the mean %TWL (40.1 ± 8.5 versus 34.8 ± 8.9; P = .334).
Banded RYGB leads to significant and sustained weight loss in a 10-year follow-up. Despite a slight late weight regain evaluated by %TWL, RYGB leads to an optimal weight loss in the majority of the individuals.
评估带环 Roux-en-Y 胃旁路术（RYGB）在 10 年随访期间的减肥效果。
巴西，私立医疗服务机构。
对 928 例肥胖患者进行前瞻性研究，这些患者均接受带环 RYGB 治疗。根据患者的初始体重指数（BMI）将其分为两组，病态肥胖（BMI 35-49.9 kg/m）和超级肥胖（BMI≥50 kg/m）。评估并比较手术后 18、24、36、48、60、72、84、96、108 和 120 个月时的超重减轻百分比（%EWL）和总体重减轻百分比（%TWL），并评估手术失败率。
每年都有患者失访，18 个月时失访 423 例（45.6%），24 个月时失访 431 例（46.4%），36 个月时失访 482 例（51.9%），48 个月时失访 568 例（61.2%），60 个月时失访 658 例（70.9%），72 个月时失访 725 例（78.1%），84 个月时失访 781 例（84.2%），96 个月时失访 819 例（88.3%），108 个月时失访 838 例（90.3%），120 个月时失访 819 例（88.3%）。最大的%EWL 是在 18 个月时实现的（P<.001）。10 年后，平均 BMI（28.7 ± 4.1 与 28.5 ± 3.6 kg/m；P =.07）或%EWL（80.4 ± 19.1 与 79.7 ± 23.4；P =.065）没有显著变化，但病态肥胖组的平均%TWL 在 10 年时显著降低（30.8 ± 8.5 与 32.5 ± 8.1；P =.035），与 5 年时的结果相比。在超级肥胖组中，%EWL 从 24 个月时的 77.7 ± 16.5 kg/m 显著下降至 72 个月时的 71.3 ± 18.1 kg/m（P =.008）；在 5 年时，平均 BMI（33.1 ± 5.8 kg/m）与 10 年时的 BMI（36.4 ± 5 kg/m；P =.21）无差异，平均%TWL（40.1 ± 8.5 与 34.8 ± 8.9；P =.334）也无差异。
带环 RYGB 在 10 年随访期间可显著且持续地减轻体重。尽管通过%TWL 评估发现晚期体重略有增加，但 RYGB 仍可使大多数患者获得理想的减重效果。
