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瑞典可调节胃束带术:初步经验

Swedish adjustable gastric banding: a preliminary experience.

作者信息

Catona A, La Manna L, La Manna A, Sampiero C

机构信息

Divisione di Chirurgia Generale Casa di Cura Beato Matteo-Vigevano-PV, Pavia, Italy.

出版信息

Obes Surg. 1997 Jun;7(3):203-5; discussion 206. doi: 10.1381/096089297765555737.

Abstract

BACKGROUND

The authors have been performing bariatric surgery for 15 years; since February 1992 they have carried out laparoscopic gastric banding (LGB) with a silastic band. Good experience with the LGB combined with everyday laparoscopic activity in their institution persuaded them to try laparoscopic placement of the Swedish adjustable gastric band (SAGB).

METHODS

The surgical procedure is the same as that for laparoscopic gastric banding except for the use of a 15 mm trocar that is required to introduce the band, and the need to place a port that is connected to the band via a wide loop tube; the port is place subcutaneously and is supported by the lower part of the sternum. The authors do not use any abdominal drain nor a naso-gastric tube. At surgery the band is left empty, and filling is usually not started until 4 weeks after surgery. The patient is immediately mobilized and begins a liquid diet the evening after the operation. The patients are usually discharged from hospital on the first postoperative day.

RESULTS

Over 8 months, 24 patients underwent SAGB, with mean BMI 44.69 and mean operating time 45 minutes (range 30-75). No early complications occurred. Preliminary results in this small series show BMIs of 38.65 and 34.60 at 3 and 6 months postoperation.

CONCLUSION

SAGB appears for be a good method for obesity surgery. It is easy to perform and is associated with a low operative risk. Provided that the band is put in the right place, weight loss can be adjusted to patient comfort.

摘要

背景

作者开展减肥手术已有15年;自1992年2月起,他们采用硅橡胶带进行腹腔镜胃束带术(LGB)。LGB的良好经验以及他们机构日常的腹腔镜手术活动促使他们尝试腹腔镜置入瑞典可调节胃束带(SAGB)。

方法

手术步骤与腹腔镜胃束带术相同,不同之处在于需要使用15mm的套管针来引入束带,并且需要置入一个通过宽环管与束带相连的端口;该端口置于皮下,由胸骨下部支撑。作者不使用任何腹腔引流管或鼻胃管。手术时束带保持空置,通常在术后4周才开始充盈。患者术后立即活动,术后当晚开始流食。患者通常在术后第一天出院。

结果

在8个月的时间里,24例患者接受了SAGB手术,平均体重指数(BMI)为44.69,平均手术时间为45分钟(范围30 - 75分钟)。未发生早期并发症。这个小系列的初步结果显示术后3个月和6个月时的BMI分别为38.65和34.60。

结论

SAGB似乎是一种很好的肥胖症手术方法。它操作简便,手术风险低。只要束带放置位置正确,体重减轻程度可根据患者舒适度进行调整。

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