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首页> 外文期刊>Surgical Endoscopy >A 6-year experience with the Swedish adjustable gastric band Prospective long-term audit of laparoscopic gastric banding.
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A 6-year experience with the Swedish adjustable gastric band Prospective long-term audit of laparoscopic gastric banding.

机译：瑞典可调式胃束带的6年工作经验对腹腔镜胃束带进行长期的前瞻性审计。

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BACKGROUND: In morbid obesity conservative therapy often fails to reduce overweight permanently. As a consequence, several bariatric surgical procedures have been developed to achieve permanent excess weight loss. Among these, the laparoscopic restrictive procedures seem to be the least invasive. The aim of this prospective study was to assess and analyze the effects, complications, and outcomes after the implantation of the Swedish adjustable gastric band (SAGB) in long-term follow-up. METHODS: All consecutive patients with implantation of a SAGB between August 1996 and August 2002 were prospectively investigated. The placement of the SAGB was done by laparoscopy in all cases. Success was rated by the reduction of body mass index (BMI) excess weight loss (EWL), and reduction of comorbidities. "Nonresponders" to SAGB were defined as <30% EWL after a 3-year follow-up. Band-related complications were recorded and classified. Patient's outcome was assessed after 6 months and subsequently each year postoperatively. RESULTS: A total of 190 patients received a SAGB, 97% of whom could be followed up with a mean follow-up period of 39.4 months (duration of follow-up, 6-72). During follow-up, a significant reduction or improvement of BMI, EWL, and comorbidities were found. Nineteen percent of patients were identified as nonresponders. Early intraoperative and postoperative complications related to SAGB were one perforation of the gastric fundus (0.5%), one conversion (0.5%), one bleeding (0.5%), and two band infections (1.1%). The SAGB-related complications encountered during long-term follow-up were three port problems (1.6%), four band migrations (2.1%), five slipping/pouch dilatations (2.6%), and two band leakages (1.1%). All intra- and postoperative SAGB-related complications accounted for a total morbidity of 10.5%. Operative mortality was 0%. The overall reoperation rate was 8.5%. CONCLUSIONS: In long-term follow-up, SAGB is safe and effective. Our results demonstrate a significant EWL of 50% during the first 24 months. However, patient selection has to be improved to reduce the nonresponder rate. SAGB leads to a significant reduction of obesity-related comorbidities. SAGB is an attractive alternative in the surgical treatment of morbid obesity.
机译：背景：在病态肥胖症中，保守治疗通常无法永久减轻超重。结果，已经开发了几种减肥手术方法以实现永久的过度减肥。其中，腹腔镜限制性手术似乎是侵入性最小的。这项前瞻性研究的目的是评估和分析在长期随访中植入瑞典可调节胃带（SAGB）后的效果，并发症和结局。方法：对1996年8月至2002年8月期间所有连续植入SAGB的患者进行前瞻性研究。在所有情况下，均通过腹腔镜检查放置SAGB。通过降低体重指数（BMI），过度减肥（EWL）和减少合并症来评定成功。经过3年的随访，SAGB的“无反应者”被定义为EWL <30％。记录与乐队相关的并发症并进行分类。六个月后评估患者的结局，术后每年进行评估。结果：总共190例患者接受了SAGB，其中97％可以接受随访，平均随访时间为39.4个月（随访时间为6-72）。在随访期间，发现BMI，EWL和合并症显着降低或改善。百分之十九的患者被确定为无反应者。与SAGB相关的早期术中和术后并发症为胃底穿孔1处（0.5％），胃底穿孔1处（0.5％），出血1处（0.5％）和两条带状感染（1.1％）。长期随访中遇到的与SAGB相关的并发症是三个端口问题（1.6％），四个频段迁移（2.1％），五个滑套/囊袋扩张（2.6％）和两个频段泄漏（1.1％）。术中和术后所有与SAGB相关的并发症占总发病率的10.5％。手术死亡率为0％。总体再手术率为8.5％。结论：在长期随访中，SAGB是安全有效的。我们的结果表明，在最初的24个月中，EWL达到了50％。但是，必须改进患者选择以降低无应答率。 SAGB可显着减少与肥胖相关的合并症。 SAGB在病态肥胖的外科手术治疗中是一种有吸引力的替代方法。

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