Revisional bariatric surgery: who, what, where, and when?
Revisional bariatric surgery: who, what, where, and when?
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DOI：
10.1016/j.soard.2010.04.005
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发表时间：
2010-11-01
影响因子：
3.1
通讯作者：
Cooney, Robert N.
中科院分区：
文献类型：
--
作者：
Radtka, John F., III;Puleo, Frances J.;Cooney, Robert N.
背景：肥胖矫正手术（RBS）的结局特征不明确。我们比较了在宾夕法尼亚州立大学米尔顿S。方法：回顾2000年至2007年共72例RBS病例，并按适应症分组：体重减轻失败、胃空肠并发症或其他。将RBS患者与接受Roux-en-Y胃旁路术的856例PBS患者进行比较。RBS组的平均随访时间为12.6 ± 1.2个月，PBS组为16 ± 0.5个月。体重减轻被分析为体重减轻的公斤数和体重减轻>= 50%的患者（EBWL）。结果：RBS后体重减轻23 +/- 2.8 kg，PBS后体重减轻41.3 +/- 0.7 kg（P <0.05 vs PBS）。RBS后体重减轻因手术适应症而异：体重减轻失败，27.1 ± 2 kg;胃空肠并发症，8.7 ± 3.4 kg;其他23.5 ± 10.6 kg。此外，29%的RBS患者体重减轻>= 50%（与翻修前体重相比），61%（与初始体重相比），而PBS后为52.7%。仅年龄= 50%的超重体重减轻后RBS为减肥失败组。无RBS患者死亡。然而，泄漏，手术部位感染，住院时间增加后RBS.Conclusion：我们的研究结果表明，RBS后的体重减轻随手术指征而变化，并受到年龄>50岁的影响。尽管与PBS患者相比，RBS患者体重减轻减少，并发症增加，但大量RBS患者实现了>= 50%EBWL。(Surg肥胖相关疾病2010;6：635-642。(C)2010年美国代谢和减肥外科学会。All rights reserved.
Background: Revisional bariatric surgery (RBS) outcomes have been poorly characterized. We compared the RBS and primary bariatric surgery (PBS) outcomes at the Penn State Milton S. Hershey Medical Center in the United States.Methods: A total of 72 RBS cases from 2000 to 2007 were reviewed and grouped by indication: failure of weight loss, gastrojejunal complications, or other. The RBS patients were compared with the 856 PBS patients who underwent Roux-en-Y gastric bypass. The mean follow-up time was 12.6 +/- 1.2 months for the RBS group and 16 +/- 0.5 months for the PBS group. Weight loss was analyzed as the kilograms lost and patients with >= 50% excess body weight loss (EBWL). Outcomes included mortality, leaks, surgical site infections, and length of stay.Results: The weight loss was 23 +/- 2.8 kg after RBS and 41.3 +/- 0.7 kg after PBS (P < .05 versus PBS). The post-RBS weight loss varied by surgical indication: failure of weight loss, 27.1 +/- 2 kg; gastrojejunal complications, 8.7 +/- 3.4 kg; and other 23.5 +/- 10.6 kg. Also, 29% of the RBS patients had >= 50% excess body weight loss (versus the prerevision weight) and 61% (versus the initial weight) compared with 52.7% after PBS. Only age = 50% excess body weight loss after RBS for the failure of weight loss group. No RBS patients died. However, leaks, surgical site infections, and length of stay were increased after RBS.Conclusion: The results of our study have shown that weight loss after RBS varies with the surgical indication and is affected by age >50 years. Although the RBS patients had decreased weight loss and increased complications compared with the PBS patients, >= 50% EBWL was achieved by a significant number of RBS patients. (Surg Obes Relat Dis 2010;6:635-642.) (C) 2010 American Society for Metabolic and Bariatric Surgery. All rights reserved.