Department of Surgery, Minimally Invasive Surgery and Bariatric Surgery, Beth Israel Deaconess Medical Center, Boston, USA.
Surg Endosc. 2022 Oct;36(10):7781-7788. doi: 10.1007/s00464-022-09278-8. Epub 2022 May 9.
Despite many patients doing well after laparoscopic adjustable gastric band (LAGB) several studies caution offering this procedure for weight loss. The aim of our study was to review our long-term results over a decade.
Following IRB approval, the Metabolic and Bariatric Surgery Quality Improvement Program (MBSAQIP) Data Registry was used to identify LAGB placement between 2007 and 2013 by a single surgeon. We sought to determine complications of initial operation, weight loss and resolution of comorbidities over time, the indications for reoperation including removal, revision or conversion to another weight loss surgery. Chi-square test was used to analysis.
From 403 LAGB performed between January 2007 and December 2013, 75 patients required reoperation with total 79 procedures, including band revision and/or conversion. Mean follow-up time was 5.78 years (73.67 months). The rate of reoperation was at least 18.61%. There were 60 band removals, 10 band revisions, 9 conversions to either sleeve or gastric bypass. Only 16 patients (20.25%) required reoperation due to inadequate weight loss. Band slippage/prolapse remained the most common non weight-related indication for reoperation (23, 29.11%). Reoperation associated with longer length of stay compared to index procedures (2.12 days vs 1.63 days, p < 0.0001) but no statistical difference in 30_days_complication. Of those who did not require reoperation, BMI at 10th year follow-up was 37.50 from initial BMI of 42.23 with EWL of 39.22%.
Lap band is effective for most patients with long-term durability. Over time approximately one fifth will need additional surgery. Only one fifth of reoperation relates to inadequate weight loss.
尽管许多患者在腹腔镜可调节胃带（LAGB）手术后恢复良好，但仍有几项研究对该手术用于减肥持谨慎态度。我们研究的目的是回顾过去十年的长期结果。
在获得机构审查委员会批准后，使用代谢和减重手术质量改进计划（MBSAQIP）数据登记处，由一位外科医生确定在 2007 年至 2013 年间进行 LAGB 放置。我们试图确定初始手术的并发症、随时间推移的体重减轻和合并症的解决情况，以及再次手术的指征，包括带的移除、修改或转换为另一种减肥手术。采用卡方检验进行分析。
在 2007 年 1 月至 2013 年 12 月期间，共有 403 例 LAGB 患者，其中 75 例患者需要再次手术，共进行了 79 例手术，包括带的修改和/或转换。平均随访时间为 5.78 年（73.67 个月）。再次手术的比例至少为 18.61%。有 60 例带的移除，10 例带的修改，9 例转换为袖套或胃旁路。仅有 16 例（20.25%）因体重减轻不足需要再次手术。带的滑脱/脱垂仍然是最常见的非体重相关再次手术指征（23 例，29.11%）。与初次手术相比，再次手术的住院时间更长（2.12 天 vs 1.63 天，p < 0.0001），但 30 天并发症无统计学差异。在不需要再次手术的患者中，第 10 年随访时的 BMI 为初始 BMI 的 37.50，而 EWL 为 39.22%。
腹腔镜胃带对大多数患者长期有效。随着时间的推移，大约五分之一的患者需要进行额外的手术。只有五分之一的再次手术与体重减轻不足有关。
