Orłowski Michał, Janik Michał, Franczak Paula, Frask Agata, Michalik Maciej
Department of General and Oncological Surgery, Ceynowa Hospital, Wejherowo, Poland.
Department of General, Oncologic, Metabolic and Thoracic Surgery, Military Institute of Medicine, Warsaw, Poland.
Wideochir Inne Tech Maloinwazyjne. 2020 Mar;15(1):166-170. doi: 10.5114/wiitm.2019.86773. Epub 2019 Jul 22.
The gastric band is still offered as a good bariatric option for highly motivated and carefully selected patients. The question is whether this faith is justified or not.
To assess long-term clinical outcomes of patients who underwent laparoscopic adjustable gastric banding (LAGB) at a single bariatric center and to examine variables associated with patients' adherence to scheduled postoperative appointments.
A retrospective review of patients who underwent LAGB between 2004 and 2009 was performed. The initial cohort included 167 patients. Data regarding sex, age, preoperative weight, hometown population and distance from the bariatric center, and gastric band volume were collected. Compliance was measured as the number of postoperative appointments. Clinical outcome was defined as percent excess weight loss (%EWL) at the end of the observation period or at band removal.
The LAGB was performed in 167 patients between 2004 and 2009. The mean follow-up time was 90 ±24 months. Five (3%) patients were lost to follow-up; 37 (22.2%) had their band removed. The remaining 125 (74.8%) patients retained their bands and were included in the analysis. The mean %EWL was 33.0 ±26.6%. Thirty-one (18.6%) patients achieved %EWL > 50%.
This study found that LAGB was not an effective bariatric procedure in long-term observation. Only 25% of 125 patients who maintained a functioning band achieved %EWL > 50%. Compliance was the only independent prognostic factor for weight loss. Other factors had no influence on outcome.
对于积极性高且经过精心挑选的患者，胃束带术仍是一种不错的减肥选择。问题在于这种信念是否合理。
评估在单一减肥中心接受腹腔镜可调节胃束带术（LAGB）的患者的长期临床结局，并检查与患者遵守术后预约相关的变量。
对2004年至2009年间接受LAGB的患者进行回顾性研究。初始队列包括167名患者。收集了有关性别、年龄、术前体重、家乡人口及与减肥中心的距离以及胃束带容量的数据。依从性以术后预约次数衡量。临床结局定义为观察期末或取出束带时的超重减轻百分比（%EWL）。
2004年至2009年间对167名患者实施了LAGB。平均随访时间为90±24个月。5名（3%）患者失访；37名（22.2%）患者取出了束带。其余125名（74.8%）患者保留了束带并纳入分析。平均%EWL为33.0±26.6%。31名（18.6%）患者的%EWL>50%。
本研究发现，长期观察中LAGB并非有效的减肥手术。在125名保留有效束带的患者中，只有25%的患者%EWL>50%。依从性是体重减轻的唯一独立预后因素。其他因素对结局无影响。
