Jense Marijn T F, Bruinsma Floris F E, Nienhuijs Simon W, Liem Ronald S L, de Mheen Perla J Marang-van, Greve Jan Willem M, Boerma Evert-Jan G
Zuyderland Medisch Centrum, Sittard, Netherlands.
Maastricht University, Maastricht, Netherlands.
Obes Surg. 2025 Mar;35(3):884-893. doi: 10.1007/s11695-025-07706-x. Epub 2025 Jan 30.
The ring-augmented Roux-en-Y gastric bypass (raRYGB) has been reported to result in higher long-term weight loss compared to regular Roux-en-Y gastric bypass (RYGB). However, the type of ring used varied within studies, leading to heterogeneity in reported results. Therefore, this study compares the 5-year results of RYGB with and without ring augmentation using a specific prefabricated gastric ring.
All consecutive patients from a single center who received primary raRYGB between June 1, 2016, and May 31, 2018, with complete 5-year follow-up data were included and compared to a propensity score matched cohort receiving RYGB in the same period from the Dutch Audit for Treatment of Obesity. To ensure fair effect estimation of placing a ring, only RYGB procedures with alimentary and biliopancreatic limb lengths similar to those of the raRYGB were considered eligible. The primary outcome was percentage total weight loss (%TWL). Secondary outcomes included recurrent weight gain (RWG), obesity complication improvement, and complications.
In total, 592 matched patients were analyzed. raRYGB was associated with higher %TWL at 5 years (31.5% versus 28.0%, β = 3.59, 95% CI [2.09-5.09], p < 0.01) and lower odds on RWG (odds ratio = 0.56, 95% CI [0.38-0.83], p < 0.01). Improvement of obesity complications and short-term complication rates were comparable in both groups. After 5 years, 13 patients (4%) had experienced ring-related complications needing reoperation.
At 5 years, raRYGB was associated with higher %TWL and lower odds on RWG. The occurrence of ring-related complications was limited.
据报道，与常规 Roux-en-Y 胃旁路术（RYGB）相比，环形增强 Roux-en-Y 胃旁路术（raRYGB）能带来更高的长期体重减轻。然而，各研究中使用的环形装置类型有所不同，导致报告结果存在异质性。因此，本研究使用一种特定的预制胃环，比较了有和没有环形增强的 RYGB 的 5 年结果。
纳入了 2016 年 6 月 1 日至 2018 年 5 月 31 日期间在单一中心接受初次 raRYGB 且有完整 5 年随访数据的所有连续患者，并与荷兰肥胖治疗审计中同期接受 RYGB 的倾向评分匹配队列进行比较。为确保对放置环形装置的效果进行公平评估，仅考虑消化道和胆胰肢长度与 raRYGB 相似的 RYGB 手术为合格。主要结局是总体重减轻百分比（%TWL）。次要结局包括体重反复增加（RWG）、肥胖并发症改善情况和并发症。
总共分析了 592 例匹配患者。raRYGB 在 5 年时与更高的 %TWL 相关（31.5% 对 28.0%，β = 3.59，95% CI [2.09 - 5.09]，p < 0.01），且 RWG 的几率更低（优势比 = 0.56，95% CI [0.38 - 0.83]，p < 0.01）。两组肥胖并发症的改善情况和短期并发症发生率相当。5 年后，13 例患者（4%）出现了需要再次手术的与环形装置相关的并发症。
在 5 年时，raRYGB 与更高的 %TWL 和更低的 RWG 几率相关。与环形装置相关的并发症发生率有限。
