Department of General and Visceral Surgery, Centre for Surgery, Centre for Obesity and Metabolic Surgery, Medical Centre, University of Freiburg, Hugstetter Strasse 55, 79106, Freiburg, Germany.
Obes Surg. 2024 Feb;34(2):310-317. doi: 10.1007/s11695-023-06982-9. Epub 2023 Dec 18.
Banded sleeve gastrectomy (BSG) has been shown to enable better weight loss than non-banded sleeve gastrectomy (SG) in retrospective analyses. These findings were supported by two randomized controlled trials (RCT). However, to date, mid-term prospective data is not available.
We invited all 94 patients of an RCT comparing banded to non-banded sleeve gastrectomy at 3 years (DRKS00007729) for a 5-year follow-up visit. Eighty-two patients (BSG n = 42; SG n = 40) came for evaluation. Outcome measures were identical with the RCT to allow longitudinal comparison. Data analysis was descriptive and focused on biometric data, development of comorbidities, mid-term complications, quality of life, and type of body contouring surgery (BCS).
The per-protocol analysis revealed a treatment difference of 9% (CI - 1.5 to 19.6) excess weight loss (EWL). Total weight loss (TWL) was 27.4% (CI 23.5-31.3) after SG and 31.6% (CI 27.3-35.5) after BSG. Twenty percent of patients after SG and 11.9% following BSG had been converted to a gastric bypass. Type 2 diabetes went into remission in most patients (SG 66.7% vs. BSG 63.6%). Antihypertensive medication was stopped or reduced in 81.3% after SG and 80% after BSG. Reflux symptoms were similar in both groups (symptoms [Formula: see text] 1/ week: SG 28.2% vs. BSG 26.8%). Frequency of postprandial regurgitation was higher after BSG (SG 23% vs. BSG 59%). Forty percent of patients had undergone BCS at time of follow-up.
Five-year weight loss after BSG was 9% EWL and 4.2% TWL higher compared to SG. The main added morbidity following BSG was postprandial regurgitation.
带袖套胃切除术（BSG）在回顾性分析中显示比非带袖套胃切除术（SG）能更好地减轻体重。这一发现得到了两项随机对照试验（RCT）的支持。然而，迄今为止，中期前瞻性数据尚不可用。
我们邀请了在比较带袖套和非带袖套胃切除术的 3 年 RCT（DRKS00007729）中的 94 名患者进行 5 年随访。82 名患者（BSG 组 n=42；SG 组 n=40）接受了评估。结果测量与 RCT 相同，以便进行纵向比较。数据分析是描述性的，重点是生物统计学数据、合并症的发展、中期并发症、生活质量以及身体整形手术（BCS）的类型。
意向治疗分析显示，BSG 组的额外体重减轻（EWL）为 9%（CI-1.5 至 19.6）。SG 组的总体重减轻（TWL）为 27.4%（CI 23.5-31.3），BSG 组为 31.6%（CI 27.3-35.5）。SG 组有 20%的患者和 BSG 组有 11.9%的患者转为胃旁路术。大多数患者的 2 型糖尿病进入缓解期（SG 组 66.7%，BSG 组 63.6%）。SG 组有 81.3%的患者停止或减少了降压药物，BSG 组有 80%的患者停止或减少了降压药物。两组的反流症状相似（每周症状[Formula: see text]1/次：SG 组 28.2%，BSG 组 26.8%）。BSG 组餐后反流的频率更高（SG 组 23%，BSG 组 59%）。40%的患者在随访时接受了 BCS。
BSG 后 5 年的体重减轻量为 EWL 增加 9%，TWL 增加 4.2%，高于 SG。BSG 后主要的附加发病率是餐后反流。
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