Department of Surgery B, Carmel Medical Center, 3436212, Haifa, Israel.
Department of Surgery C, Meirav Breast Health Center, Chaim Sheba Medical Center, Tel Hashomer Hospital, Sackler School of Medicine,Tel-Aviv University, Tel Aviv-Yafo, Israel.
Obes Surg. 2020 May;30(5):1808-1813. doi: 10.1007/s11695-020-04448-w.
Silastic ring vertical gastroplasty (SRVG) was a popular restrictive procedure 2 and 3 decades ago. However, it was associated with severe complications and a high rate of reoperation due to failure. Examination of long-term outcomes of those patients that underwent SVRG is limited. The aim of our study was to determine the long-term outcomes (over 13 years) of SRVG in our institution and to review the literature of long-term outcomes following SVRG.
Following IRB approval, we reviewed patients who underwent SRVG between 1996 and 2001. Weight loss parameters, preoperative comorbidities, were compared to the follow-up data.
In total, 92 patients underwent SRVG, and 89 met the inclusion criteria. Mean age was 52.4 ± 10.6 years and body mass index (BMI) was 46.1 ± 6.5 Kg/m. Preoperative comorbidities rate included diabetes mellitus (19.1%), hypertension (32.5%), hyperlipidemia (21.3%), joints disease (6.7%), mood disorders (7.8%), and dyspeptic disorders (3.3%). Mean length of follow-up was 208.5 ± 16.8 months. Thirty-eight patients (43%) had to be reoperated due to complications and 24 (30%) had an additional bariatric surgery. Follow-up BMI was 34.2 ± 9.8 Kg/m (p < 0.001). There was no improvement in any of the comorbidities; incidence of joint disease and dyspeptic disorders were significantly higher at the follow-up (p = 0.03, p < 0.001, respectively).
SRVG procedure was associated with high rates of reoperations and revisions. The majority of our patients showed poor resolution of comorbidities and even worsening of some. Our data confirms that SRVG is not suitable as a bariatric procedure.
硅酮环垂直胃成形术(SRVG)在 20 至 30 年前是一种流行的限制性手术。然而,由于失败,它与严重的并发症和高再手术率有关。对接受 SVRG 治疗的患者进行长期结果检查的研究有限。我们研究的目的是确定我们机构中 SRVG 的长期结果(超过 13 年),并回顾 SVRG 长期结果的文献。
在获得机构审查委员会批准后,我们回顾了 1996 年至 2001 年间接受 SRVG 的患者。将体重减轻参数与随访数据进行比较。
共有 92 例患者接受了 SRVG,其中 89 例符合纳入标准。平均年龄为 52.4±10.6 岁,体重指数(BMI)为 46.1±6.5 Kg/m。术前合并症发生率包括糖尿病(19.1%)、高血压(32.5%)、高血脂(21.3%)、关节疾病(6.7%)、情绪障碍(7.8%)和消化不良疾病(3.3%)。平均随访时间为 208.5±16.8 个月。由于并发症,38 例患者(43%)需要再次手术,24 例(30%)进行了额外的减重手术。随访时 BMI 为 34.2±9.8 Kg/m(p<0.001)。没有任何合并症得到改善;在随访时,关节疾病和消化不良疾病的发生率明显更高(p=0.03,p<0.001)。
SRVG 手术与高再手术率和修订率相关。我们的大多数患者显示出合并症治疗效果不佳,甚至有些合并症恶化。我们的数据证实,SRVG 不适合作为减重手术。