Is there a benefit to preoperative weight loss in gastric bypass patients? A prospective randomized trial
Is there a benefit to preoperative weight loss in gastric bypass patients? A prospective randomized trial
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DOI：
10.1016/j.soard.2006.11.006
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发表时间：
2007-03-01
影响因子：
3.1
通讯作者：
Curet, Myriam J.
中科院分区：
文献类型：
--
作者：
Alami, Ramzi S.;Morton, John M.;Curet, Myriam J.
背景：Roux-en-Y胃旁路手术是美国治疗病态肥胖的主要手术。术前体重减轻在胃旁路手术中的作用仍有争议。我们进行了一项前瞻性随机试验，以确定术前体重减轻是否会导致腹腔镜胃旁路手术的更好结果。方法：选取2004年5月至2005年10月行腹腔镜胃旁路手术的100例患者，术前随机分为减重10%组和无减重要求组。对患者进行前瞻性随访。分析的变量包括围手术期并发症、手术时间、术后体重减轻和合并症的解决。结果：减肥组26例，非减肥组35例。两组患者术前特征、转归率、并发症发生率及合并症的缓解情况相似。减肥组和非减肥组的初始体重指数分别为48.7 kg/m(2)和49.3 kg/m(2) （P = NS）。减肥组和非减肥组术前体重指数分别为44.5 kg/m(2)和50.7 kg/m(2)，差异有统计学意义（P = 0.0027）。两组手术时间分别为220.2分钟和257.6分钟（P = 0.0084）。减肥组和非减肥组在第3个月和第6个月的体重减轻率分别为44.1%和33.1% (P = 0.0267)， 53.9%和50.9% （P = NS）。两组患者从初次就诊到手术的时间间隔分别为5.4个月和5.2个月（P = NS）。结论：腹腔镜Roux-en-Y胃旁路术前体重减轻与手术时间的减少和短期内体重减轻百分比的提高有关。然而，术前体重减轻并不影响主要并发症或转换率，其长期影响在本研究中并不明显。此外，术前体重减轻对合并症的解决没有任何影响。（外科学杂志2007；3:141-146。）(C) 2007年美国减肥外科学会。版权所有。
Background: Roux-en-Y gastric bypass surgery is the leading surgical treatment of morbid obesity in the United States. The role of preoperative weight loss in gastric bypass surgery remains controversial. We performed a prospective randomized trial to determine whether preoperative weight loss results in better Outcomes after laparoscopic gastric bypass.Methods: A total of 100 patients undergoing laparoscopic gastric bypass surgery from May 2004 to October 2005 were randomized preoperatively to either 1 weight loss group with a 10% weight loss requirement or a group that had no weight loss requirements. The patients were followed prospectively. The variables analyzed included perioperative complications, operative time, postoperative weight loss, and resolution of co-morbidities.Results: Data were available for 26 patients in the weight loss group and 35 in the nonweight loss group. The 2 groups had similar preoperative characteristics, conversion and complication rates, and resolution of co-morbidities. The initial body mass index was 48.7 kg/m(2) and 49.3 kg/m(2) for the weight loss group and nonweight loss group, respectively (P = NS). The preoperative body mass index was 44.5 kg/m(2) and 50.7 kg/m(2) for the weight loss group and nonweight loss group, respectively (P = 0.0027). The operative time was 220.2 and 257.6 minutes for the 2 groups (P = 0.0084). The percentage of excess weight loss at 3 and 6 months for the weight loss group and nonweight loss group was 44.1% and 33.1% (P = 0.0267) and 53.9% and 50.9% (P = NS), respectively. The interval to surgery from the initial consultation was 5.4 months and 5.2 months for the 2 groups (P = NS).Conclusions: Preoperative weight loss before laparoscopic Roux-en-Y gastric bypass was associated with a decrease in the operating room time and an improved percentage of excess weight loss in the short term. Preoperative weight loss, however, did not affect the major complication or conversion rates, and its long-term effects were not apparent through this study. Also, preoperative weight loss did not have any bearing on the resolution of co-morbidities. (Surg Obes Relat Dis 2007; 3:141-146.) (C) 2007 American Society for Bariatric Surgery. All rights reserved.