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首页> 外文期刊>Annals of Surgery >Safety of Revision Sleeve Gastrectomy Compared to Roux-Y Gastric Bypass After Failed Gastric Banding
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Safety of Revision Sleeve Gastrectomy Compared to Roux-Y Gastric Bypass After Failed Gastric Banding

机译：修复套筒胃切除术的安全性与胃带状发生故障后的Roux-Y胃旁路相比

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Objective: The aim of this study was to assess the safety of revisional surgery to laparoscopic sleeve gastrectomy (LSG) compared to laparoscopic Roux-Y gastric bypass (LRYGB) after failed laparoscopic adjustable gastric banding (LAGB).Background: The number of reoperations after failed gastric banding rapidly increased in the United States during the last several years. A common approach is band removal with conversion to another weight loss procedure such as gastric bypass or sleeve gastrectomy in a single procedure. The safety profile of those procedures remains controversial.Methods: Preoperative characteristics and 30-day outcomes from the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program Participant Use Files 2015 were selected for all patients who underwent a 1-stage conversion of LAGB to LSG (conv-LSG) or LRYGB (conv-LRYGB). Conv-LSG cases were matched (1:1) with conv-LRYGB patients by age (? year), body mass index (?kg/m~(2)), sex, and comorbidities including diabetes, hypertension, hyperlipidemia, venous stasis, and sleep apnea.Results: A total of 2708 patients (1354 matched pairs) were included in the study. The groups were closely matched as intended. The mean operative time in conv-LRYGB was significantly longer in comparison to conv-LSG patients (151?58 vs 113?45minutes, P < 0.001). No mortality was observed in either group. Patients after conv-LRYGB had a clinically increased anastomotic leakage rate (2.07% vs 1.18%, P = 0.070) and significantly increased bleed rate (2.66% vs 0.44%, P < 0.001). Thirty-day readmission rate was significantly higher in conv-LRYGB patients (7.46% vs 3.69%, P < 0.001), as was 30-day reoperation rate (3.25% vs 1.26%, P < 0.001). The length of hospital stay was longer in conv-LRYGB.Conclusions: A single-stage conversion of failed LAGB leads to greater morbidity and higher complication rates when converted to LRYGB versus LSG in the first 30 days postoperatively. These differences are particularly notable with regards to bleed events, 30-day reoperation, 30-day readmission, operative time, and hospital stay.
机译：目的：该研究的目的是评估腹腔镜调节胃粘器（LAGB）.Background后的腹腔镜Roux-Y胃旁路（LryGB）与腹腔镜Roux-Y胃旁路（LSG）对腹腔镜套管胃切除术（LSG）的安全性的安全性。在过去的几年中，美国胃部扎带失败迅速增加。一种常见的方法是随着在单个程序中转化为另一种体重减轻过程的带去除，例如胃旁路或套管胃切除术。这些程序的安全性概况仍然是争议。 conv-lsg）或lrygb（conv-lrygb）。 Conv-LSG病例与Conv-LryGB患者匹配（1：1），按年龄（？一年），体重指数（？kg / m〜（2）），性别和糖尿病，高血压，高脂血症，静脉瘀血和睡眠呼吸暂停。结果：该研究中共有2708名患者（1354对成对的成对）。这些群体与预期相匹配。与Conv-LSG患者相比，Conv-LryGB中的平均手术时间明显更长（151〜58 vs 113？45分钟，P <0.001）。在任一组中没有观察到死亡率。 Conv-LryGB后的患者临床上增加了吻合漏率（2.07％Vs 1.18％，P = 0.070），渗出率显着增加（2.66％Vs 0.44％，P <0.001）。 Conc-Lrygb患者的30天登记率明显高于7.46％Vs 3.69％，P <0.001），如30天的再式速率（3.25％Vs 1.26％，P <0.001）。 Conv-LryGB.Concluctions的医院住宿时间更长：失败的LAGB的单阶段转换导致在术后前30天转换为LryGB与LSG时更大的发病率和更高的并发症率。这些差异对于流血事件，30天的重新入口，30天的入院，手术时间和住院住宿而言特别显着。

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