Department of Surgery, NewYork-Presbytertian Brooklyn Methodist Hospital, 506 Sixth Street, Brooklyn, NY, 11215, USA.
Surg Endosc. 2021 Sep;35(9):5315-5321. doi: 10.1007/s00464-020-08021-5. Epub 2020 Sep 28.
Laparoscopic Roux-en-Y gastric bypass (LRYGB) still remains the gold-standard bariatric procedure. Short-term weight loss and improvement of type 2 diabetes mellitus (DM2) after LRYGB are well-documented. Little data are available on long-term weight loss and continued remission of DM2 in these patients.
This study reports on weight loss and remission of DM2 in 576 consecutive patients who underwent primary LRYGB between August 2001 and August 2009 with at least 10-year follow up. All patients were treated at a single institution by a single surgeon. All data were collected and entered into the database prospectively.
A total of 576 patients were included in the study. Patients' mean age was 38.2 ± 10.9 years and females represented 88.2% of patients. Patients' ethnicity was diverse, including African Americans (44.4%), Caucasians (34.0%), Hispanics (18.1%), and 3.5% from other backgrounds. On average, there were 6.9 ± 2.7 comorbidities per patient and DM2 was initially present in 150/576 patients (26.0%). Mean preoperative weight and BMI were 132.4 ± 22.0 kg and 48.3 ± 6.7 kg/m, respectively. Ten-year follow-up reporting rate was 145/576 (25.2%). Maximum weight loss occurred at 18 months (mean weight 83.4 ± 16.5 kg, mean BMI 30.5 ± kg/m). At 10 years, mean weight was maintained at 94.8 ± 20.5 kg and mean BMI was 34.3 ± 6.8 kg/m. The average weight regain between one and ten years was 8.27 kg. Among patients with preoperative DM2, continued remission of DM2 at 10 years occurred in 19/32 (59.4%) patients.
LRYGB provides durable long-term weight loss, as well as successful remission of DM2 at 10 years. More long-term follow-up studies evaluating weight loss and comorbidities extending beyond the initial 10-year period are needed. Such studies are essential for projecting late outcomes of LRYGB, particularly in younger patients with life expectancy exceeding several decades.
腹腔镜 Roux-en-Y 胃旁路术（LRYGB）仍然是减重手术的金标准。LRYGB 术后短期的体重减轻和 2 型糖尿病（DM2）的改善已有充分记录。关于这些患者的长期体重减轻和 DM2 的持续缓解的数据较少。
本研究报告了 576 例连续患者在 2001 年 8 月至 2009 年 8 月期间接受初次 LRYGB 手术的体重减轻和 DM2 缓解情况，这些患者至少随访 10 年。所有患者均在一家机构由一位外科医生进行治疗。所有数据均前瞻性地收集并输入数据库。
共有 576 例患者纳入本研究。患者的平均年龄为 38.2±10.9 岁，女性占患者的 88.2%。患者的种族多样，包括非裔美国人（44.4%）、白种人（34.0%）、西班牙裔（18.1%）和 3.5%的其他背景。平均每位患者有 6.9±2.7 种合并症，576 例患者中有 150 例（26.0%）最初患有 DM2。术前平均体重和 BMI 分别为 132.4±22.0kg 和 48.3±6.7kg/m。10 年随访报告率为 145/576（25.2%）。最大减重发生在 18 个月（平均体重 83.4±16.5kg，平均 BMI 30.5±kg/m）。10 年后，平均体重维持在 94.8±20.5kg，平均 BMI 为 34.3±6.8kg/m。1 至 10 年间的平均体重增加为 8.27kg。在术前患有 DM2 的患者中，19/32（59.4%）患者在 10 年后仍持续缓解 DM2。
LRYGB 可提供持久的长期体重减轻，并在 10 年内成功缓解 DM2。需要更多长期随访研究来评估 10 年以上的减重和合并症。这些研究对于预测 LRYGB 的晚期结果至关重要，特别是在预期寿命超过几十年的年轻患者中。
