Roux-en-Y 胃旁路手术是一种安全有效的选择，可以改善老年退伍军人肥胖相关的主要合并症。
Roux-en-Y gastric bypass is a safe and effective option that improves major Co-Morbidities associated with obesity in an older, veteran population.
机构信息
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.
出版信息
Am J Surg. 2019 Oct;218(4):684-688. doi: 10.1016/j.amjsurg.2019.07.027. Epub 2019 Jul 20.
BACKGROUND
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.
METHODS
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).
RESULTS
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.
CONCLUSIONS
RYGB offers sustained, long-term weight loss with significant resolution of major comorbidities in older veterans, with acceptably low morbidity and mortality.
背景
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。
方法
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。
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。
结论
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。
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