Crampton N A, Izvornikov V, Stubbs R S
Wakefield Gastroenterology Centre, Wakefield Hospital, Wellington, New Zealand.
Obes Surg. 1997 Dec;7(6):495-9. doi: 10.1381/096089297765555241.
The silastic ring (vertical) 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 VBG, while avoiding disadvantages of each. We remain unsure of the ideal ring size.
Sixty-four patients having SRGB between June 1990 and September 1994 had a 5.5 cm ring placed and 24 patients operated between October 1994 and September 1995 had a 6.0 cm ring placed. Weight loss and quality of eating data is compared 12 months after surgery.
Median preoperative per cent excess weight was 113 (range 76-209) in the 5.5 cm group and 106 (range 79-196) in the 6.0 cm group. Weight loss was equivalent at 12 months, with median percent excess weight of 33 (range 8-109) and 27 (range 6-81) in the two groups respectively. Quality of eating data appears better in those with the larger ring size. Nine patients with a 5.5 cm ring have subsequently had their ring removed to improve their quality of eating and a further six may require this in the future. One patient with a 6.0 cm ring has had the ring removed and two others may require this be done.
An SRGB with a 6.0 cm ring achieves equivalent weight loss to one with a 5.5 cm ring, but with better quality of eating, and less prospect of requiring ring removal. However, there remains a small proportion of patients in whom a 6.0 cm ring is poorly tolerated. For this reason a 6.5 cm ring should be tested.
1989年，福比引入了硅胶环（垂直）胃旁路术（SRGB），旨在将Roux-en-Y胃旁路术的优点与垂直胃成形术的优点相结合，同时避免各自的缺点。我们仍不确定理想的环尺寸。
1990年6月至1994年9月期间接受SRGB手术的64例患者放置了5.5厘米的环，1994年10月至1995年9月期间接受手术的24例患者放置了6.0厘米的环。比较术后12个月的体重减轻情况和饮食质量数据。
5.5厘米组术前超重百分比中位数为113（范围76 - 209），6.0厘米组为106（范围79 - 196）。两组在12个月时体重减轻情况相当，两组超重百分比中位数分别为33（范围8 - 109）和27（范围6 - 81）。环尺寸较大者的饮食质量数据似乎更好。9例佩戴5.5厘米环的患者随后取出了环以改善饮食质量，未来可能还有6例需要这样做。1例佩戴6.0厘米环的患者已取出环，另外2例可能需要这样做。
使用6.0厘米环的SRGB与使用5.5厘米环的SRGB减重效果相当，但饮食质量更好，且需要取环的可能性更小。然而，仍有一小部分患者对6.0厘米的环耐受性较差。因此，应测试6.5厘米的环。
