Taşkin M, Apaydin B B, Zengin K, Taşkin U
Istanbul University, Cerrahpaşa Medical Faculty, General Surgery Department, Turkey.
Obes Surg. 1997 Oct;7(5):424-8. doi: 10.1381/096089297765555412.
Among gastric restrictive operations, the procedure of choice is still controversial. The aim of this study is to compare the results of two different gastric restrictive procedures: vertical banded gastroplasty (VBG) and stoma adjustable silicone gastric banding (ASGB).
Between 1991 and 1996, 51 patients were treated surgically for morbid obesity: 27 underwent VBG and 24 underwent ASGB. Preoperative body weight (BW), body mass index (BMI) and percentage of ideal body weight (% IBW) were (mean+/-SD): 145.7+/-45.3 kg; 53.9+/-15.9 kg/m2; 249.1+/-73.5% respectively in the VBG group. Corresponding figures for the ASBG group were 132.5+/-22.7 kg; 46.9 7.8 kg/m2 and 207.2+/-35.0%.
In the VBG group, the median follow-up period was 26 months (range: 7-47). Eighteen months after the operation BW, BMI, % IBW and percentage of excess weight loss (% EWL) were 85.5+/-26.8 kg, 31.9+/-9.8 kg/m2, 145.4+/-43.9% and 74+/-1% respectively. Complications included incisional hernia (n=1), and bowel obstruction (n=1). One patient died of acute myocardial infarction on the third postoperative day. In the ASGB group, median follow-up time was 19.7 months (range: 18-26). At 18 months postoperation BW, BMI, % IBW and % EWL values were 86.6+/-20.6 kg 30.6+/-6.6 kg/m2 140.6+/-29.3% and 64+/-1% respectively. Gastric wall erosion occurred in two patients and the bands had to be removed. These patients underwent VBG 6 months later. Complications encountered in this group were incisional hernia (n=1), outlet stenosis and reflux esophagitis (n=1), reservoir leakage (n=1) and gastrointestinal bleeding (n=1). Two patients died of pulmonary embolism and acute gastrointestinal bleeding.
Weight reduction was not statistically significant between the two groups. ASGB was easier to perform and less invasive than VBG.
在胃限制性手术中，首选的手术方式仍存在争议。本研究的目的是比较两种不同胃限制性手术的结果：垂直捆扎胃成形术（VBG）和可调节硅胶胃束带术（ASGB）。
1991年至1996年间，51例患者接受了肥胖症手术治疗：27例行VBG，24例行ASGB。术前体重（BW）、体重指数（BMI）和理想体重百分比（%IBW）（均值±标准差）在VBG组分别为：145.7±45.3kg；53.9±15.9kg/m²；249.1±73.5%。ASBG组的相应数据为132.5±22.7kg；46.9±7.8kg/m²和207.2±35.0%。
在VBG组，中位随访期为26个月（范围：7 - 47个月）。术后18个月，BW、BMI、%IBW和超重减轻百分比（%EWL）分别为85.5±26.8kg、31.9±9.8kg/m²、145.4±43.9%和74±1%。并发症包括切口疝（n = 1）和肠梗阻（n = 1）。一名患者在术后第三天死于急性心肌梗死。在ASGB组，中位随访时间为19.7个月（范围：18 - 26个月）。术后18个月，BW、BMI、%IBW和%EWL值分别为86.6±20.6kg、30.6±6.6kg/m²、140.6±29.3%和64±1%。两名患者发生胃壁糜烂，束带不得不移除。这两名患者在6个月后接受了VBG。该组遇到的并发症有切口疝（n = 1）、出口狭窄和反流性食管炎（n = 1）、贮器渗漏（n = 1）和胃肠道出血（n = 1）。两名患者死于肺栓塞和急性胃肠道出血。
两组之间体重减轻无统计学显著差异。ASGB比VBG更容易实施且侵入性更小。
