Frering V, Honnorat D, Riou J P, Partensky C
Fédération des Spécialités Digestives, Hôpital Edouard-Herriot, LYON.
Ann Chir. 1996;50(2):139-45.
Morbid obesity, defined by Body Mass Index (BMI) > 40 kg/m2, has an adverse effect on longevity due to a variety of illnesses. Among the numerous techniques proposed to control morbid obesity, Vertical Banded Gastroplasty (VBG) changes eating behavior. The aim of this study was to analyse the long term results of VBG.
Between October 1987 and July 1993, 62 patients, 7 men and 55 women, from 20 to 68 years old (Mean: 37.4 +/- 9 ans), underwent VBG for morbid obesity. Preoperative mean weight and BMI were 123 +/- 27 kg and 47.3 +/- 9.8 kg/m2 respectively. Associated diseases were diabetes mellitus (n = 31), hypertension (N = 29), hypercholesterolemia (N = 10), hypertriglyceridemia (N = 21) and joint diseases (N = 18).
VBG was performed with a 50 mm marlex mesh in 20 cases and with a 47 to 50 mm silastic ring in 42 cases. On patient died 3 years later from alcoholic liver cirrhosis and 4 were lost to follow-up. With a mean follow-up of 31 months, mean weight and BMI were 86 +/- 21 kg (p < 0.001) and 32.1 +/- 9.8 kg/m2 (p < 0.001) respectively. Removal of the ring was performed in 3 cases, 1 because of neurologic complications and 2 at the patient's request. Eight patients (13%) failed to achieve satisfactory weight loss. Diabetes mellitus and hypertension resolved in 19 cases, hypercholesterolemia resolved in 7 cases and hypertriglyceridemia resolved in 11.
VBG provides significant weight loss which reduces the frequency of medical disorders associated with obesity. This result was achieved in 87% of patients. The surgical procedure for morbid obesity must be decided conjointly with endocrinologist, psychiatrist and surgical staff for good long-term results.
病态肥胖由体重指数（BMI）>40kg/m²定义，由于多种疾病，其对寿命有不利影响。在众多被提议用于控制病态肥胖的技术中，垂直束带胃成形术（VBG）改变了进食行为。本研究的目的是分析VBG的长期结果。
在1987年10月至1993年7月期间，62例患者（7例男性和55例女性），年龄在20至68岁（平均：37.4±9岁），因病态肥胖接受了VBG手术。术前平均体重和BMI分别为123±27kg和47.3±9.8kg/m²。相关疾病包括糖尿病（n = 31）、高血压（n = 29）、高胆固醇血症（n = 10）、高甘油三酯血症（n = 21）和关节疾病（n = 18）。
20例患者使用50mm的马利克斯网进行VBG手术，42例患者使用47至50mm的硅橡胶环进行手术。1例患者3年后死于酒精性肝硬化，4例失访。平均随访31个月时，平均体重和BMI分别为86±21kg（p < 0.001）和32.1±9.8kg/m²（p < 0.001）。3例患者取出了环，1例是因为神经并发症，2例是应患者要求。8例患者（13%）未能实现满意的体重减轻。19例糖尿病和高血压患者病情缓解，7例高胆固醇血症患者病情缓解，11例高甘油三酯血症患者病情缓解。
VBG能显著减轻体重，降低与肥胖相关的疾病发生率。87%的患者取得了这一结果。病态肥胖的手术治疗必须由内分泌学家、精神科医生和外科医护人员共同决定，以获得良好的长期效果。
