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带环 Roux-en-Y 胃旁路术的减重效果和并发症:一项前瞻性病例对照研究的经验教训。

Weight loss and complications of the banded Roux-en-Y gastric bypass: lessons learned from a prospective case control study.

机构信息

General Surgery, Albury Wodonga Health, Albury Campus, 201 Borella Rd, Albury, NSW, 2640, USA.

出版信息

Surg Endosc. 2022 Oct;36(10):7516-7520. doi: 10.1007/s00464-022-09184-z. Epub 2022 Mar 16.

DOI:10.1007/s00464-022-09184-z
PMID:35294635
Abstract

OBJECTIVE

Obesity is a growing global health burden which is particularly challenging to manage. Bariatric surgery is considered the most effective means of sustained weight loss, and Roux-en-Y gastric bypass is considered the most effective treatment for morbid obesity. The additional benefit of placing a non-adjustable band to form a banded Roux-en-Y gastric bypass has gained interest as a measure to improve weight loss; however, comparative data are few, and complications can be high.

METHODS

We conducted a prospective case-control study of 484 patients aged 18 and over who received either banded Roux-en-Y gastric bypass with a non-adjustable silastic ring or Roux-en-Y gastric bypass. Patients were followed up for five years and evaluated for weight loss, percentage excess weight loss (%EWL), BMI, and band-related complications.

RESULTS

No significant difference was detected in %EWL or BMI between BRYGB and RYGB. The mean raw weight loss, %EWL, and BMI for BRYGB verse RYGB were as follows: 27.49 SD (17.11) kg verse 34.46 SD (18.18) kg, 65.7% SD (30%) verse 62.2% SD (37%), and 32.33 SD (6.9) kg/m verse 32.43 SD (7.2) kg/m. A total of 80 (21.7%) patients had the non-adjustable band removed for complications.

CONCLUSION

There is little difference in weight-loss results when comparing BRYGB to RYGB and non-adjustable bands may cause significant complications.

摘要

目的

肥胖是一个日益严重的全球健康负担,尤其难以管理。减重手术被认为是持续减肥的最有效手段,而 Roux-en-Y 胃旁路手术被认为是治疗病态肥胖的最有效方法。放置不可调节带形成带 Roux-en-Y 胃旁路术作为改善减肥效果的一种措施引起了关注;然而,比较数据很少,并发症可能很高。

方法

我们对 484 名年龄在 18 岁及以上的患者进行了前瞻性病例对照研究,这些患者接受了带不可调节硅酮环的带 Roux-en-Y 胃旁路手术或 Roux-en-Y 胃旁路手术。患者随访 5 年,评估体重减轻、多余体重百分比减轻(%EWL)、BMI 和带相关并发症。

结果

BRYGB 和 RYGB 之间在 %EWL 或 BMI 方面没有显著差异。BRYGB 与 RYGB 的平均原始体重减轻、%EWL 和 BMI 如下:27.49 SD(17.11)kg 与 34.46 SD(18.18)kg,65.7% SD(30%)与 62.2% SD(37%),32.33 SD(6.9)kg/m 与 32.43 SD(7.2)kg/m。共有 80 名(21.7%)患者因并发症而移除不可调节带。

结论

BRYGB 与 RYGB 相比,减肥效果差异不大,不可调节带可能会引起严重并发症。

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本文引用的文献

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Bariatric surgery produces greater weight loss and improvements in medical conditions than non-surgical treatment of obesity.与肥胖症的非手术治疗相比,减肥手术能带来更多的体重减轻,并改善身体状况。
Evid Based Med. 2014 Aug;19(4):138. doi: 10.1136/eb-2013-101669. Epub 2014 Mar 11.
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SILASTIC ring vertical banded gastric bypass for the treatment of obesity: two years of follow-up in 84 patients [corrected].硅橡胶环垂直束带胃旁路术治疗肥胖症:84例患者的两年随访[校正后]
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