van Helmond Sophie C, Jense Marijn T F, Verkoulen Geert H J M, De Witte Evelien, Broos Pieter P H L, Greve Jan Willem M, Boerma Evert-Jan G
Zuyderland Medisch Centrum, Sittard, Netherlands.
Maastricht University, Maastricht, Netherlands.
Obes Surg. 2025 Jul 5. doi: 10.1007/s11695-025-07984-5.
Bariatric surgery, in particular Roux-en-Y gastric bypass (RYGB), has been a well proven and effective means of long-term management of severe obesity. However, about 10-35% of patients have a suboptimal clinical response (lowest quartile of weight loss after RYGB surgery) or suffer from recurrent weight gain often resulting in additional surgery. This study investigates the short-term results on weight loss and complications of surgical revision of the pouch in combination with placement of a MiniMizer ring in patients with a suboptimal clinical response or recurrent weight gain after RYGB.
All patients who underwent pouch revision in combination with placement of a MiniMizer ring in the Zuyderland Medical Center between January 2016 and December 2021 were included. Weight, obesity-related complication resolution, and complications were monitored and reported during the follow-up appointments at the Nederlandse Obesitas Kliniek up to 2 years post-revisional surgery.
Thirty-six patients were included. These patients had a mean %TWL of 12.3 and 13.5 at 12 and 24 months post-revisional surgery. This resulted in a cumulative %TWL of 28.7 at 24 months after the revisional procedure. Patients with a superior response after the primary RYGB procedure (%TWL ≥ 35) responded better in %TWL post-revisional surgery compared to patients with a suboptimal response after the primary RYGB with a cumulative %TWL of 33.9 and 17.5 respectively. One ring-related complication occurred.
Pouch revision in combination with placement of a MiniMizer ring appears to be a promising approach for managing patients with a suboptimal clinical response or recurrent weight gain after RYGB. The procedure offers significant additional weight loss with a low complication rate.
减重手术，尤其是 Roux-en-Y 胃旁路术（RYGB），已被充分证明是长期管理重度肥胖的有效手段。然而，约 10% - 35%的患者临床反应欠佳（RYGB 手术后体重减轻处于最低四分位数）或体重反复增加，常需再次手术。本研究调查了对临床反应欠佳或 RYGB 术后体重反复增加的患者，行胃囊修复术并置入 MiniMizer 环后的短期减重效果及并发症情况。
纳入 2016 年 1 月至 2021 年 12 月在 Zuyderland 医疗中心接受胃囊修复术并置入 MiniMizer 环的所有患者。在荷兰肥胖诊所进行随访预约时，监测并报告术后长达 2 年的体重、肥胖相关并发症的缓解情况及并发症。
共纳入 36 例患者；修复术后 12 个月和 24 个月时，这些患者的平均总体重减轻百分比（%TWL）分别为 12.3 和 13.5。修复术后 24 个月时，累积%TWL 为 28.7。初次 RYGB 手术反应良好（%TWL≥35）的患者，修复术后的%TWL 反应优于初次 RYGB 手术反应欠佳的患者，累积%TWL 分别为 33.9 和 17.5。发生了 1 例与环相关的并发症。
胃囊修复术联合置入 MiniMizer 环似乎是一种有前景的方法，用于管理 RYGB 术后临床反应欠佳或体重反复增加的患者。该手术能显著增加体重减轻，且并发症发生率低。
