Gastrojejunal Stoma Diameter Predicts Weight Regain After Roux-en-Y Gastric Bypass
Gastrojejunal Stoma Diameter Predicts Weight Regain After Roux-en-Y Gastric Bypass
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DOI：
10.1016/j.cgh.2010.11.004
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发表时间：
2011-03-01
影响因子：
12.6
通讯作者：
Thompson, Christopher C.
中科院分区：
文献类型：
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作者：
Abu Dayyeh, Barham K.;Lautz, David B.;Thompson, Christopher C.
背景与目的：Roux-en-Y胃旁路术（RYGB）后体重恢复与健康状况和生活质量的下降有关。我们评估胃空肠吻合口直径是否是RYGB后体重恢复的危险因素。方法：我们研究了4年来连续患者的数据，这些患者在RYGB后转介到三级保健减肥中心进行上消化道内窥镜检查。我们使用线性回归分析来确定胃空肠吻合口直径和体重恢复之间的关联。我们应用逻辑回归模型，使用临床和内镜参数，以制定RYGB后体重增加的预测规则。结果：在我们研究的165名患者中，59%的患者体重明显恢复（RYGB后最大体重减轻>= 20%），41%的患者体重没有恢复。在整个队列中，RYGB后恢复的最大体重减轻的平均百分比为30% +/-22%。在单变量分析中，胃空肠吻合口直径与RYGB手术后体重恢复显著相关（β = 0.31，P <0.0001）。在调整了几个已知的或声称的体重反弹风险因素后，这种关联仍然显着（β = .19，P = .003）。我们开发了一个简单的预测规则，使用7分评分系统，包括胃空肠吻合口直径，种族，和RYGB后最大体重减轻的百分比，RYGB后体重恢复; 4分或以上的截止评分的受试者工作特征曲线下面积为0.76，阳性预测值为75%。结论：胃空肠吻合口直径增加是RYGB后体重恢复的危险因素，可以纳入新的预测规则。
BACKGROUND & AIMS: Weight regain after Roux-en-Y gastric bypass (RYGB) is associated with reductions in health status and quality of life. We evaluated whether gastrojejunal stoma diameter is a risk factor for weight regain after RYGB. METHODS: We examined data collected over 4 years from consecutive patients referred to a tertiary care bariatric center for upper endoscopy after RYGB. We used linear regression analysis to determine the association between the gastrojejunal stoma diameter and weight regain. We applied a logistic regression model using clinical and endoscopic parameters to develop a prediction rule for weight gain after RYGB. RESULTS: Among 165 patients included in our study, 59% had significant weight regain (>= 20% of maximum weight lost after the RYGB) and 41% did not. The mean percentage of maximal weight lost after RYGB that was regained in the entire cohort was 30% +/- 22%. Gastrojejunal stoma diameter was associated significantly with weight regain after RYGB surgery in univariate analysis (beta = .31, P < .0001). This association remained significant after adjusting for several known or purported risk factors for weight regain (beta = .19, P = .003). We developed a simple prediction rule for weight regain after RYGB using a 7-point scoring system that includes the gastrojejunal stoma diameter, race, and percentage of maximal body weight lost after RYGB; a cut-off score of 4 or more points had an area under receiver operating characteristic curve of 0.76 and a positive predictive value of 75%. CONCLUSIONS: Increased gastrojejunal stoma diameter is a risk factor for weight regain after RYGB and can be incorporated in a novel prediction rule.