可调节胃束带术后的翻修手术:袖状胃切除术还是胃旁路手术?

Revisional Surgery After Adjustable Gastric Banding: Sleeve Gastrectomy or Gastric Bypass?

作者信息

Park Young Suk

机构信息

Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea.

Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.

出版信息

J Metab Bariatr Surg. 2022 Dec;11(2):49-53. doi: 10.17476/jmbs.2022.11.2.49. Epub 2023 Mar 2.

Abstract

Adjustable gastric banding was the most common type of bariatric surgery performed in Korea prior to 2019. Many patients that have undergone this procedure require revisional bariatric surgery while removing the gastric band, and it is important to select an appropriate revisional procedure. If reoperation is performed owing to insufficient weight loss or weight regain, a 1-step procedure can be considered. However, a 2-step procedure is preferred when complications such as band erosion or stomach perforation have occurred. Previous studies from Western countries have shown that revisional Roux-en-Y gastric bypass (RYGB) can achieve more effective postoperative weight loss than revisional sleeve gastrectomy, although this procedure may also carry a higher risk of morbidity, reoperation, and readmission to hospital. In Korea, the short-term outcomes of the 2 procedures may be similar. However, the potential risk of gastric cancer in the remnant stomach after RYGB must also be considered. The type of revisional surgery should be selected following discussions with the patient regarding the advantages and disadvantages associated with each procedure.

摘要

在2019年之前,可调节胃束带术是韩国最常见的减肥手术类型。许多接受过该手术的患者在移除胃束带时需要进行减肥手术修正,选择合适的修正手术很重要。如果因减肥不足或体重反弹而进行再次手术,可以考虑一步法手术。然而,当发生诸如束带侵蚀或胃穿孔等并发症时,两步法手术更为可取。西方国家此前的研究表明,修正性Roux-en-Y胃旁路术(RYGB)比修正性袖状胃切除术能实现更有效的术后减肥效果,尽管该手术也可能具有更高的发病、再次手术和再次入院风险。在韩国,这两种手术的短期结果可能相似。然而,RYGB术后残胃发生胃癌的潜在风险也必须予以考虑。应在与患者讨论每种手术的优缺点后选择修正手术的类型。

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