University of California San Francisco Department of Surgery and the San Francisco Veterans Affairs Health Care System, 513 Parnassus Avenue, S321, San Francisco, CA, 94143-0470, USA.
University of California San Francisco Department of Medicine and the San Francisco Veterans Affairs Health Care System, 4150 Clement Street, San Francisco, CA, 94121, USA.
Am J Surg. 2019 Oct;218(4):684-688. doi: 10.1016/j.amjsurg.2019.07.027. Epub 2019 Jul 20.
Though over one-third of veterans suffer from obesity and its associated comorbidities, bariatric surgery (deleted: is seldom offered) is less commonly offered than in other populations.
We reviewed surgical outcomes using CPRS/Vista data of ("deleted 308) 315 Roux-en-Y gastric bypass (RYGB) cases performed at a major VA Medical Center (1995-2017).
Patients were 69% male, with an average age 52 (65% over 50), and were followed for an average of 8 years; 158 (51%) underwent laparoscopic surgery, and the remaining open. Outcomes were: 30-day mortality- Open: 1.3%, Lap: 0%; anatomic leak-open: 0.3%, Lap: 0%. A total of 32 (10%) Clavien-Dindo ≥3 complications occurred. At 5 and 15 years, average BMI decreased from 47 preoperatively to 33.3 and 31 respectively, while excess body weight loss was 68%, and 80%, respectively. Co-morbidity resolution rates were between 70 and 80% diabetes, sleep apnea, hyperlipidemia, GERD, (delete - hypertension), and NASH.
RYGB offers sustained, long-term weight loss with significant resolution of major comorbidities in older veterans, with acceptably low morbidity and mortality.
尽管超过三分之一的退伍军人患有肥胖症及其相关合并症，但与其他人群相比，很少为他们提供减重手术。
我们使用 CPRS/Vista 数据回顾了在一家大型退伍军人事务医疗中心（1995-2017 年）进行的 315 例 Roux-en-Y 胃旁路术（RYGB）的手术结果。
患者中男性占 69%，平均年龄为 52 岁（65%超过 50 岁），平均随访 8 年；158 例（51%）接受了腹腔镜手术，其余为开放性手术。结果如下：30 天死亡率-开放性：1.3%，腹腔镜：0%；解剖性漏-开放性：0.3%，腹腔镜：0%。共有 32 例（10%）发生了 Clavien-Dindo ≥3 级并发症。在 5 年和 15 年时，平均 BMI 从术前的 47 降至 33.3 和 31，而超重体重减轻分别为 68%和 80%。糖尿病、睡眠呼吸暂停、高脂血症、GERD（删除-高血压）和 NASH 的合并症缓解率在 70%至 80%之间。
RYGB 为老年退伍军人提供了持续的、长期的体重减轻，并显著缓解了主要合并症，发病率和死亡率均较低。
