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首页> 外文期刊>Surgical Endoscopy >Case-matched analysis comparing outcomes of revisional versus primary laparoscopic Roux-en-Y gastric bypass
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Case-matched analysis comparing outcomes of revisional versus primary laparoscopic Roux-en-Y gastric bypass

机译：病例匹配分析比较了修订型和原发性腹腔镜Roux-en-Y胃搭桥术的结果

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Background: Laparoscopic Roux-en-Y gastric bypass (LRYGB) is one of the most common approaches used to revise post-bariatric patients with inadequate weight loss or significant weight regain. Previous studies have analyzed the outcomes of open revisional RYGB versus primary RYGB, but no case-control matched analysis comparing revisional LRYGB versus primary LRYGB has been performed. Methods: Our cohort includes 37 consecutive patients who underwent revisional LRYGB because of unsatisfactory weight loss or weight regain matched in a 1:2 ratio with 74 control patients who underwent primary LRYGB. Matching included the following parameters: age, gender, preoperative body mass index and comorbidities (diabetes, obstructive sleep apnea, and hypertension). Results: The revisional group had longer length of stay compared with the primary group (3.8 vs. 2.4 days, P = 0.02) and a higher conversion to laparotomy rate (10.8 vs. 0 %, P = 0.01). The revisional group had a higher 30-day morbidity compared with the primary group (27 vs. 8.1 %, P = 0.02). There were no deaths in both groups. The two groups had similar 30-day readmission and 30 day reoperation rates. At 3, 6, and 12 months of follow-up, the revisional LRYGB group had significantly lower percent of excess weight loss (EWL) than the primary LRYGB group (3 months, 30 vs. 38.4, P = 0.001; 6 months, 36.3 vs. 52.9, P = 0.001; 12 months, 46.5 vs. 68.2, P = 0.001). Conclusions: Revisional LRYGB is characterized by lower EWL and higher morbidity than primary LRYGB. However, our data suggest that revisional LRYGB is still capable of providing significant weight loss in these high-risk patients.
机译：背景：腹腔镜Roux-en-Y胃旁路术（LRYGB）是用于减肥后体重不足或体重明显减轻的重症患者的最常用方法之一。先前的研究已经分析了开放性修订RYGB与原发性RYGB的结局，但尚未进行病例对照对照分析以比较修订性LRYGB和原发性LRYGB。方法：我们的队列研究包括连续37例因体重减轻或体重恢复不理想而接受修订LRYGB的患者，与74例接受原发LRYGB的对照患者以1：2的比例相匹配。匹配包括以下参数：年龄，性别，术前体重指数和合并症（糖尿病，阻塞性睡眠呼吸暂停和高血压）。结果：修订组的住院天数比初级组更长（分别为3.8天和2.4天，P = 0.02），并且开腹手术的转换率更高（10.8对0％，P = 0.01）。与第一组相比，修订组的30天发病率更高（27％vs. 8.1％，P = 0.02）。两组均无死亡。两组的30天再入院率和30天再手术率相似。在随访的3、6和12个月时，LRYGB修订版组的体重减轻百分比（EWL）明显低于主要LRYGB组（3个月，30对比38.4，P = 0.001; 6个月，36.3） vs. 52.9，P = 0.001; 12个月，46.5 vs. 68.2，P = 0.001）。结论：修订型LRYGB的EWL和发病率均高于原发性LRYGB。但是，我们的数据表明，修订的LRYGB仍然能够在这些高风险患者中提供显着的体重减轻。

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