First report from the American College of Surgeons Bariatric Surgery Center Network: laparoscopic sleeve gastrectomy has morbidity and effectiveness positioned between the band and the bypass.
First report from the American College of Surgeons Bariatric Surgery Center Network: laparoscopic sleeve gastrectomy has morbidity and effectiveness positioned between the band and the bypass.
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DOI：
10.1097/sla.0b013e31822c9dac
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发表时间：
2011-09
影响因子：
9
通讯作者：
Nguyen NT
中科院分区：
文献类型：
--
作者：
Hutter MM;Schirmer BD;Jones DB;Ko CY;Cohen ME;Merkow RP;Nguyen NT
评估腹腔镜袖状胃切除术（LSG）与腹腔镜可调节胃束带（LAGB）、腹腔镜Roux-en-Y胃旁路术（LRYGB）和开放式Roux-en-Y胃旁路术（ORYGB）相比治疗肥胖和肥胖相关疾病的安全性和有效性。LSG是一种较新的手术，频率越来越高。然而，有限的数据，目前比较LSG的其他既定程序。我们提出了第一个前瞻性的，多机构的，全国性的，临床上丰富的，减肥的具体数据比较袖状胃切除术，可调节胃束带和胃旁路。这是分析来自美国外科医生学会-减肥手术中心网络认证计划的数据的初步报告，其前瞻性，纵向，基于标准化定义的数据收集系统，由受过培训的数据审查员收集。单变量和多变量分析比较了30天、6个月和1年的结局，包括发病率和死亡率、再入院和再手术以及体重指数（BMI）降低和体重相关合并症。2007年7月至2010年9月，109家医院提交了28，616名患者的数据。与LAGB相比，LSG的风险调整后发病率、再入院率和再手术/干预率较高，但与LRYGB和ORYGB相比，再手术/干预率较低。死亡率无差异。LSG后BMI和大多数体重相关合并症的降低也介于LAGB和LRYGB/ORYGB之间。LSG的发病率和有效性介于LAGB和LRYGB/ORYGB之间，数据长达1年。由于肥胖是一种终身疾病，因此更长期的比较有效性数据最为关键，但尚未确定。
To assess the safety and effectiveness of the laparoscopic sleeve gastrectomy (LSG) as compared to the Laparoscopic Adjustable Gastric Band(LAGB), the Laparoscopic Roux-en-Y Gastric Bypass(LRYGB) and the Open Roux-en-Y Gastric Bypass(ORYGB) for the treatment of obesity and obesity-related diseases. LSG is a newer procedure being done with increasing frequency. However, limited data are currently available comparing LSG to the other established procedures. We present the first prospective, multi-institutional, nationwide, clinically-rich, bariatric-specific data comparing sleeve gastrectomy to the adjustable gastric band and the gastric bypass. This is the initial report analyzing data from the American College of Surgeons – Bariatric Surgery Center Network accreditation program, and its prospective, longitudinal, data collection system based on standardized definitions and collected by trained data reviewers. Univariate and multivariate analyses compare 30-day, 6-month, and one-year outcomes including morbidity and mortality, readmissions and reoperations as well as reduction in body mass index (BMI) and weight-related comorbidities. 109 hospitals submitted data for 28,616 patients, from 7/2007 to 9/2010. The LSG has higher risk-adjusted morbidity, readmission and reoperation/intervention rates compared to the LAGB, but lower reoperation/intervention rates compared to the LRYGB and ORYGB. There were no differences in mortality. Reduction in BMI and most of the weight-related comorbidities following the LSG also lies between those of the LAGB and the LRYGB/ORYGB. LSG has morbidity and effectiveness positioned between the LAGB and the LRYGB/ORYGB for data up to one year. As obesity is a lifelong disease, longer term comparative effectiveness data are most critical, and are yet to be determined.