Freeman J B, Burchett H
Am J Surg. 1983 Jan;145(1):113-9. doi: 10.1016/0002-9610(83)90176-9.
One hundred twenty-two morbidly obese patients were selected for gastric partitioning from a multidisciplinary obesity clinic over a 4 year period. Initial early success was not a guarantee against cessation of weight loss or the regaining of lost weight. By emphasizing criteria for success and failure, both from our series and the literature, we showed an alarming increase in the failure rates for this procedure which is predicated on the fact that those lost to follow-up were probably failure patients. Numerous articles in the literature contain inadequate data because they refer to pounds rather than percentage of weight loss, they fail to consider revisions as failures, they do not provide 24 month follow-up data, and they do not take into account the possibility that those lost to follow-up are failure patients. The operation carries mortality and serious morbidity rates of 0 to 3 percent and 4 to 10 percent, respectively, with an average 28 percent weight loss at 24 months and a minimal failure rate of 50 percent. The alarming increase in the number of these procedures being carried out across the continent makes it mandatory for surgeons to accurately collect and register their data until the long-term effects and results are known. Gastric partitioning, although probably not experimental, is still developmental. The widespread use and possibly abuse of these operations may result in discreditation of the surgical approach to morbid obesity which would be unfortunate since it is the only practical method at this time for dealing with the problem.
在4年时间里，从一家多学科肥胖诊所挑选了122名病态肥胖患者进行胃分隔术。最初的早期成功并不能保证不会停止减重或体重反弹。通过强调我们的系列研究以及文献中的成功与失败标准，我们发现该手术的失败率出现了惊人的上升，而这一情况是基于那些失访的患者很可能是失败患者这一事实。文献中的众多文章数据不充分，因为它们提及的是磅数而非体重减轻的百分比，它们没有将翻修手术视为失败案例，没有提供24个月的随访数据，也没有考虑到失访患者可能是失败患者这一可能性。该手术的死亡率和严重并发症发生率分别为0%至3%和4%至10%，24个月时平均体重减轻28%，最低失败率为50%。在整个大陆进行的此类手术数量惊人地增加，这使得外科医生必须准确收集和记录他们的数据，直到了解其长期影响和结果。胃分隔术虽然可能不属于实验性手术，但仍处于发展阶段。这些手术的广泛使用甚至可能滥用，可能会导致治疗病态肥胖的手术方法信誉受损，而这将是不幸的，因为目前这是解决该问题的唯一可行方法。
