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接受腹腔镜可调节胃束带术患者的长期结果。

Long-term results of the patients who were applied laparoscopic adjustable gastric banding.

作者信息

Özden Sabri, Saylam Barış, Avşar Fatih Mehmet

机构信息

Clinic of Surgery, Ankara Numune Training and Research Hospital, Ankara, Turkey.

出版信息

Turk J Surg. 2018 Sep 18;35(2):79-85. doi: 10.5578/turkjsurg.4038. eCollection 2019 Jun.

Abstract

OBJECTIVES

The most effective treatment step in morbid obesity is surgical treatment. The purpose of the present study was to investigate the long-term follow-up results and success rates in laparoscopic adjustable gastric banding.

MATERIAL AND METHODS

The change in body mass index, percentage of excess weight loss, comorbidities, and resulting complications were investigated in 220 patients who were morbidly obese and applied laparoscopic adjustable gastric band between April 2006 and February 2012, throughout the 6-year follow-up period. Forty-six patients who did not show up for their routine follow-ups were excluded from the study.

RESULTS

In the present study, band removal percentage was 35.63%. The percentage of excess weight loss in patients who were followed up without removal of the band was 46.03%. Complications were observed in 46.5% of the patients. The most frequently observed complication among the major complications was band intolerance, which is also the most common cause of band removal. Band removal was considered as a failure in laparoscopic adjustable gastric band operations, and patients were referred to other surgical methods.

CONCLUSION

When improved patient compliance and careful and close patient follow-up are provided in the early stages of laparoscopic adjustable gastric band application, it may be possible to reach percentage of excess weight loss results that would be the nearest to those achieved by gastric bypass or sleeve gastrectomy methods. However, high complication rates and necessity to perform other bariatric surgical procedures in the majority of the patients in the long-term follow-up suggest that the laparoscopic adjustable gastric band operation is not the first choice in bariatric surgery.

摘要

目的

病态肥胖最有效的治疗手段是手术治疗。本研究的目的是调查腹腔镜可调节胃束带术的长期随访结果及成功率。

材料与方法

对220例病态肥胖患者进行研究,这些患者于2006年4月至2012年2月期间接受了腹腔镜可调节胃束带术,并在整个6年随访期内对其体重指数变化、超重减轻百分比、合并症及由此产生的并发症进行了调查。46例未进行常规随访的患者被排除在研究之外。

结果

在本研究中,束带移除率为35.63%。未移除束带的随访患者超重减轻百分比为46.03%。46.5%的患者出现了并发症。主要并发症中最常观察到的是束带不耐受,这也是束带移除的最常见原因。在腹腔镜可调节胃束带手术中,束带移除被视为失败,患者被转至其他手术方法。

结论

在腹腔镜可调节胃束带应用的早期阶段,若能提高患者依从性并对患者进行仔细密切的随访,则有可能达到最接近胃旁路术或袖状胃切除术所取得的超重减轻百分比结果。然而,长期随访中大多数患者的高并发症发生率以及需要进行其他减重手术的必要性表明,腹腔镜可调节胃束带手术并非减重手术的首选。

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