限制型手术后的翻修手术：一家三级中心的中期结果。
Revisional surgery after restrictive surgery: midterm outcomes of a tertiary center.
机构信息
Department of Digestive Surgery, University Hospital of Caen, Avenue de la Côte de Nacre, 14033, Caen Cedex, France.
Department of Anesthesia, University Hospital of Caen, Caen, France.
出版信息
Surg Endosc. 2023 Oct;37(10):7686-7697. doi: 10.1007/s00464-023-10274-9. Epub 2023 Aug 2.
INTRODUCTION
Revisional bariatric surgery (RBS) is a challenging type of procedure for the surgeons due to its specific morbidity and efficiency. The RBS has a higher prevalence nowadays and this study may help to improve scarce data upon this specific topic.
METHODS
Data from 252 patients undergoing RBS after laparoscopic adjustable gastric banding (LAGB) or laparoscopic sleeve gastrectomy (LSG) between 2005 and 2019, were analyzed at 2 years of follow up. A subgroup analysis of third procedure was also performed.
RESULTS
Overall morbidity occurred in 35 patients (37%) in the LSG group and 40 patients (25%) in the LAGB group (p = 0.045). At 2 years of RBS, mean weight was 92.8 ± 26.7 kg, BMI was 33.1 ± 8.56 kg/m for patients who had RBS after LSG. When RBS was performed after LAGB, mean weight at 2 years was 90.1 ± 20.7 kg and BMI was 32.5 ± 6.45 kg/m. TWL for RBS performed after LSG was 12.7 ± 16.4% versus 25.5 ± 10.3% after LAGB (p < 0.001).
CONCLUSION
RBS after LSG seems to lead to higher overall morbidity whereas RBS after LAGB lead to more perioperative issues.
简介
由于其特定的发病率和效率，减肥手术的再次手术（RBS）对外科医生来说是一种具有挑战性的手术类型。如今，RBS 的发病率更高，这项研究可能有助于改善这一特定主题的稀缺数据。
方法
在 2005 年至 2019 年期间，对 252 例接受腹腔镜可调胃带（LAGB）或腹腔镜袖状胃切除术（LSG）后行 RBS 的患者进行了数据分析，随访 2 年。还对第三次手术进行了亚组分析。
结果
在 LSG 组中，有 35 例（37%）患者发生总体并发症，在 LAGB 组中有 40 例（25%）患者发生总体并发症（p = 0.045）。在 RBS 后 2 年，LSG 后行 RBS 的患者平均体重为 92.8 ± 26.7kg，BMI 为 33.1 ± 8.56kg/m。当 LAGB 后行 RBS 时，2 年后的平均体重为 90.1 ± 20.7kg，BMI 为 32.5 ± 6.45kg/m。LSG 后行 RBS 的 TWL 为 12.7 ± 16.4%，而 LAGB 后行 RBS 的 TWL 为 25.5 ± 10.3%（p<0.001）。
结论
LSG 后行 RBS 似乎会导致更高的总体发病率，而 LAGB 后行 RBS 会导致更多的围手术期问题。
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