Excellent Laparoscopic Gastric Bypass Outcomes Can be Achieved at a Community-Based Training Hospital With Moderate Case Volume
Excellent Laparoscopic Gastric Bypass Outcomes Can be Achieved at a Community-Based Training Hospital With Moderate Case Volume
复制标题
病例量适中的社区培训医院可以实现出色的腹腔镜胃绕道手术效果
DOI：
10.1097/sla.0b013e3181e41112
复制
发表时间：
2010
影响因子：
9
通讯作者：
M. Baker
中科院分区：
文献类型：
--
作者：
S. Kothari;Kara J. Kallies;Michelle A. Mathiason;M. Baker
目的：我们的目的是评估腹腔镜胃旁路术在中等病例量的结果。背景：腹腔镜胃旁路术是目前世界上最先进的腹腔镜手术之一。以下是一个单一的机构系列从社区医院为基础的培训计划与微创减肥手术计划。方法：将自该计划开始以来接受腹腔镜胃旁路手术的所有患者的数据输入前瞻性数据库。测量的结果包括手术时间、住院时间、主要和次要并发症以及过度体重减轻的百分比。使用2和Fisher精确检验，将结果与文献综述的已发表结果进行比较，其中包括3400多例病例。结果：2001年9月至2008年10月，700例连续患者接受腹腔镜胃旁路术。平均年龄为43.1 ± 9.5岁，83%为女性。平均初始体重为135.5 ± 22.4 kg。初始体重指数为47.9 ± 6 kg/m2。平均住院时间为2.2 ± 0.9天。手术时间为147.8 ± 31.8 min。术后1年的平均过度体重减轻百分比为72.4%。无死亡病例。与文献相比，我们实现了较低的吻合口瘘（0.3% vs. 2%，P = 0.001）和吻合口狭窄（1% vs. 4.7%，P = 0.001）发生率。结论：腹腔镜胃旁路术后的良好结果可以在社区医院为基础的程序中实现中等病例量。报销决定应该考虑项目的实际结果而不是数量。
Objective:Our objective was to assess laparoscopic gastric bypass outcomes in a moderate case volume setting. Background:Laparoscopic gastric bypass remains one of the most advanced laparoscopic procedures currently performed worldwide. The following represents a single institutional series from a community hospital-based training program with a minimally invasive bariatric surgical program. Methods:Data from all patients undergoing laparoscopic gastric bypass since the inception of the program were entered into a prospective database. Measured outcomes included length of operation, length of stay, major and minor complications, and percentage excess weight loss. Results were compared with published outcomes from a review of the literature encompassing more than 3400 cases using &khgr;2 and Fisher exact tests. Results:Between September 2001 and October 2008, 700 consecutive patients underwent laparoscopic gastric bypass. The mean age was 43.1 ± 9.5 years, and 83% were female. The mean initial weight was 135.5 ± 22.4 kg. The initial body mass index was 47.9 ± 6 kg/m2. The mean length of stay was 2.2 ± 0.9 days. The length of operation was 147.8 ± 31.8 minutes. The mean percent excess weight loss at 1-year postoperative was 72.4%. There were no mortalities. Compared with the literature, we achieved a lower rate of anastomotic leak (0.3% vs. 2%, P = 0.001) and stomal stenosis (1% vs. 4.7%, P = 0.001). Conclusions:Excellent outcomes following laparoscopic gastric bypass can be achieved in a community hospital-based program with moderate case volume. Reimbursement decisions should take into consideration a program's actual outcomes rather than volume.
影响因子：
3.1
作者：
Belle, Steven H.;Berk, Paul D.;Yanovski, Susan Z.
通讯作者：
Yanovski, Susan Z.