Department of Surgery B, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Department of Surgery C, Sheba Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Obes Surg. 2020 Sep;30(9):3296-3300. doi: 10.1007/s11695-020-04569-2.
Recent data demonstrates that laparoscopic adjustable gastric banding (LAGB) is found to be associated with high rates of weight loss failure and long-term complications. Therefore, the search for the optimal revisional bariatric procedure is ongoing.
We aim to assess the safety and efficacy of converting a failed LAGB to laparoscopic one anastomosis gastric bypass (OAGB) as a revisional procedure.
Large, metropolitan, tertiary, university hospital.
Retrospective review of patients who underwent OAGB after LAGB.Demographics, comorbidities, BMI before and after the procedure, complications, and length of stay were documented.
Fifty-seven patients underwent OAGB after LAGB. For 41 patients, the band was removed, and an OAGB was performed in a single procedure (71.9%), and 96.5% of the cases were completed laparoscopically. Postoperative complications occurred in 9 patients (15.7%), including one mortality. Average BMI decreased from 42.8 ± 7.0 to 31.3 ± 5.2 kg/m at least 1 year after surgery, representing a mean %EWL of 64.5%. There was no statistical difference in complication rates between the 1-stage and 2-stage approach.
Conversion of a failed LAGB to OAGB is effective but carries higher complication rates. Randomized controlled studies comparing different procedures are necessary to further clarify the optimal revisional bariatric operation.
最近的数据表明，腹腔镜可调节胃束带术（LAGB）与较高的减重失败率和长期并发症相关。因此，人们仍在寻找最佳的减重修复手术。
我们旨在评估将失败的 LAGB 转换为腹腔镜胃旁路手术（OAGB）作为修复手术的安全性和有效性。
大型城市三级大学附属医院。
回顾性分析接受 OAGB 治疗的 LAGB 后患者。记录患者的人口统计学、合并症、手术前后 BMI、并发症和住院时间。
57 例患者在 LAGB 后接受了 OAGB 治疗。对于 41 例患者，先移除胃束带，然后进行单次 OAGB（71.9%），96.5%的病例均采用腹腔镜完成。9 例（15.7%）患者发生术后并发症，包括 1 例死亡。术后至少 1 年，平均 BMI 从 42.8±7.0 降至 31.3±5.2 kg/m²，平均 EWL 为 64.5%。1 期和 2 期手术的并发症发生率无统计学差异。
将失败的 LAGB 转换为 OAGB 是有效的，但并发症发生率较高。需要进行随机对照研究比较不同的手术方法，以进一步明确最佳的减重修复手术。
