Khalil Medhat Mohamed Helmy, Behairy Gad, Farrag Ahmed, Elbarbary Mohab G
Department of Surgery, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Dig Surg. 2023;40(1-2):31-38. doi: 10.1159/000529603. Epub 2023 Feb 15.
Due to weight regain and GIT symptoms associated with vertical banded gastroplasty (VBG), revisional surgery is necessary. Roux-en-Y gastric bypass (RYGB) is one of the best options as a revision procedure but comes with a high complication rate.
This prospective study included 80 patients undergoing RYGB surgery at Ain Shams University Hospitals after failed VBG surgery, with up to 2 years of follow-up.
Eighty patients underwent RYGB correction after VBG. The mean age was 42 ± 6.45 (39-58) years and the mean preoperative body mass index was 45.46 ± 4.135 (38-55) kg/m2. The median length of hospital stay for the patients was 4.78 ± 1.84 days. The early postoperative complication rate was 8.7% and the reoperation rate within 30 days was 3.75%, with no mortality. Leakage and bowel injury were detected in 2 patients. After an average follow-up of 2 years, the percentage of EWL was 64.47 ± 19.3, and complete resolution of VBG-related GIT symptoms was achieved in approximately all patients. Late complications occurred in 7.5% of patients, of whom 3.75% required surgery.
Conversion to RYGB is feasible with a limited short-term complication and reoperation rate; long-term results show a nearly complete resolution of VBG-related symptoms and a statistically significant positive impact on weight loss.
由于垂直束带胃成形术(VBG)后出现体重反弹和胃肠道症状,因此需要进行翻修手术。 Roux-en-Y胃旁路术(RYGB)是作为翻修手术的最佳选择之一,但并发症发生率较高。
这项前瞻性研究纳入了80例在艾因夏姆斯大学医院接受VBG手术失败后接受RYGB手术的患者,随访时间长达2年。
80例患者在VBG术后接受了RYGB矫正。平均年龄为42±6.45(39 - 58)岁,术前平均体重指数为45.46±4.135(38 - 55)kg/m²。患者的中位住院时间为4.78±1.84天。术后早期并发症发生率为8.7%,30天内再次手术率为3.75%,无死亡病例。2例患者检测到渗漏和肠损伤。平均随访2年后,多余体重减少百分比(EWL)为64.47±19.3,几乎所有患者的VBG相关胃肠道症状均得到完全缓解。7.5%的患者发生晚期并发症,其中3.75%需要手术治疗。
转为RYGB手术是可行的,短期并发症和再次手术率有限;长期结果显示VBG相关症状几乎完全缓解,对体重减轻有统计学上显著的积极影响。