Näslund I, Wickbom G, Christoffersson E, Agren G
Acta Chir Scand. 1986 Nov;152:681-9.
Fifty-seven morbidly obese patients were randomized to gastric bypass (29) or gastroplasty (28) and observed for 24 months postoperatively. Operating time and hospital stay were longer and peroperative and postoperative complications somewhat more common in the bypass than in the gastroplasty group. But weight loss at 1 year was significantly greater and failures significantly fewer after gastric bypass. Four gastroplasties were converted to bypass after 18-24 months because of failure to lose weight. Gastric bypass was judged to be much the preferable of the two operations. Dumping occurred in some patients with bypass but not after gastroplasty. Dumping was not associated with greater weight loss. Peroperatively measured pouch volume showed significant correlation with weight loss after gastroplasty, but not after bypass. Peroperative pouch volume and postoperatively measured stoma diameter were co-acting factors, which in multiple regression analysis could explain observed variance in weight loss to about 40% after gastroplasty, but to a negligible degree after gastric bypass.
57例病态肥胖患者被随机分为胃旁路手术组（29例）和胃成形术组（28例），并在术后观察24个月。胃旁路手术组的手术时间和住院时间更长，围手术期和术后并发症比胃成形术组略多。但胃旁路手术后1年的体重减轻明显更多，失败病例明显更少。4例接受胃成形术的患者在18 - 24个月后因减肥失败而转为胃旁路手术。胃旁路手术被认为是这两种手术中更可取的。胃旁路手术的一些患者出现倾倒综合征，而胃成形术后未出现。倾倒综合征与更大程度的体重减轻无关。围手术期测量的胃囊容积与胃成形术后的体重减轻显著相关，但与胃旁路手术后无关。围手术期胃囊容积和术后测量的吻合口直径是共同作用因素，在多元回归分析中，它们可解释胃成形术后约40%的体重减轻观察差异，但对胃旁路手术后的影响可忽略不计。
