Single-stage conversions from failed gastric band to sleeve gastrectomy versus Roux-en-Y gastric bypass: results from the United Kingdom National Bariatric Surgical Registry
Single-stage conversions from failed gastric band to sleeve gastrectomy versus Roux-en-Y gastric bypass: results from the United Kingdom National Bariatric Surgical Registry
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DOI：
10.1016/j.soard.2018.06.017
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发表时间：
2018-10-01
影响因子：
3.1
通讯作者：
Welbourn, Richard
中科院分区：
文献类型：
--
作者：
Khan, Omar A.;McGlone, Emma Rose;Welbourn, Richard
背景资料：对于腹腔镜可调节胃束带失败的患者，转为Roux-en-Y胃旁路术和腹腔镜袖状胃切除术都是进一步手术治疗的选择。比较这两种手术的数据有限。国家减肥手术登记处是一个全面的英国范围内的减肥手术数据库，其中前瞻性地记录了术前人口统计学特征和临床结局。目的：比较接受一期胃束带转换为Roux-en-Y胃旁路术或腹腔镜袖状胃切除术的患者的围手术期并发症发生率和短期结局。设置：英国国家减肥手术数据库。方法：从国家减肥手术登记数据集中，我们确定了2009年至2014年间141例从胃束带到胃旁路术（113例）或袖状胃切除术（28例）的单阶段转换患者，并分析了他们的临床结局。关于围手术期结果，胃旁路术与术后再入院或再介入的发生率较高相关（16对0; P=.04）。袖状胃切除术和胃旁路术在最后随访1年时的体重减轻百分比没有差异（分别为52.1%和57.1%; P= 0.4）。结论：从带转换为袖状或旁路术提供了相当好的早期体重减轻;然而，转换为袖状与更好的围手术期安全性相关。皇冠版权所有（C）2018由Elsevier Inc.代表美国减肥外科学会All rights reserved.
Background: For patients in whom laparoscopic adjustable gastric band has failed, conversion to Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy are both options for further surgical treatment. There are limited data comparing these 2 procedures. The National Bariatric Surgery Registry is a comprehensive United Kingdom-wide database of bariatric procedures, in which preoperative demographic characteristics and clinical outcomes are prospectively recorded.Objectives: To compare perioperative complication rate and short-term outcomes of patients undergoing single-stage conversion of gastric band to Roux-en-Y gastric bypass or laparoscopic sleeve gastrectomy.Setting: United Kingdom national bariatric surgery database.Methods: From the National Bariatric Surgical Registry data set, we identified 141 patients undergoing single-stage conversion from gastric band to either gastric bypass (113) or sleeve gastrectomy (28) between 2009 and 2014, and analyzed their clinical outcomes.Results: With respect to perioperative outcomes gastric bypass was associated with a higher incidence of readmission or reintervention postoperatively (16 versus 0; P=.04). There was no difference in percentage excess weight loss between sleeve gastrectomy and gastric bypass at final follow-up at 1 year (52.1% versus 57.1% respectively; P=.4).Conclusions: Conversion from band to sleeve or bypass give comparable good early excess weight loss; however, conversion to sleeve is associated with a better perioperative safety profile. Crown Copyright (C) 2018 Published by Elsevier Inc. on behalf of American Society for Bariatric Surgery. All rights reserved.