Crampton N A, Izvornikov V, Stubbs R S
Wakefield Gastroenterology Centre, Wakefield Hospital, Wellington, New Zealand.
Obes Surg. 1997 Dec;7(6):489-94. doi: 10.1381/096089297765555232.
The silastic ring gastric bypass (SRGB) was introduced by Fobi in 1989, in an effort to combine the advantages of the Roux-en-Y gastric bypass with those of the vertical banded gastroplasty, while avoiding the disadvantages of each.
The results of our first 64 patients who underwent SRGB with a 5.5 cm ring have been reviewed with particular attention to weight loss, short- and medium-term morbidity and patient satisfaction. Most patients have had regular follow-up, and those not seen during the last 6 months were sent a postal questionnaire.
The patients included 52 females and 12 males, ranging in age from 23 to 59 years (median age=39 years) at the time of surgery. Median preoperative weight, body mass index (BMI) and % excess weight were 126 kg (range 89-253 kg), 44 kg/m2 (range 36-78 kg/m2) and 113 (range 76-209) respectively. There were no serious postoperative complications and no deaths. Median hospital stay was 7 days (range 5-14 days). Eight patients (13%) are known to have had a staple-line dihiscence. Eighteen patients (28%) have had major difficulties with eating, and in nine (14%) of these the silastic ring has been removed with resolution of the eating problems, but some gain in weight. In the 54 patients with follow-up data at 2 years, median weight was 78 kg (range 55-137 kg), median BMI was 27 kg/m2 (range 20-43 kg/m2) and mean +/- SD % excess weight loss was 69+/-16. After 2 years of follow-up, eight of 54 patients (15%) were unhappy with the results of the procedure.
SRGB is an effective, safe and well-tolerated procedure for achieving weight loss in the morbidly obese. The principal drawbacks relate to staple-line problems and eating difficulties related to the silastic ring. A 5.5 cm ring is probably too small to be ideal.
1989年，福比引入了硅橡胶环胃旁路术（SRGB），旨在将Roux-en-Y胃旁路术的优点与垂直束带胃成形术的优点相结合，同时避免各自的缺点。
回顾了我们首批64例行5.5厘米环SRGB手术患者的结果，特别关注体重减轻、短期和中期发病率以及患者满意度。大多数患者进行了定期随访，对过去6个月内未就诊的患者发送了邮政调查问卷。
患者包括女性52例，男性12例，手术时年龄在23至59岁之间（中位年龄 = 39岁）。术前体重中位数、体重指数（BMI）和超重百分比分别为126千克（范围89 - 253千克）、44千克/平方米（范围36 - 78千克/平方米）和113（范围76 - 209）。术后无严重并发症，无死亡病例。中位住院时间为7天（范围5 - 14天）。已知有8例患者（13%）出现吻合口裂开。18例患者（28%）进食有严重困难，其中9例（14%）已取出硅橡胶环，进食问题得到解决，但体重有所增加。在有2年随访数据的54例患者中，体重中位数为78千克（范围55 - 137千克），BMI中位数为27千克/平方米（范围20 - 43千克/平方米），平均超重减轻百分比为69 ± 16。随访2年后，54例患者中有8例（15%）对手术结果不满意。
SRGB是一种有效、安全且耐受性良好的手术方法，可用于病态肥胖患者减重。主要缺点与吻合口问题以及与硅橡胶环相关的进食困难有关。5.5厘米的环可能太小，并非理想选择。
