Laparoscopic Roux-en-Y gastric bypass: 10-year follow-up
Laparoscopic Roux-en-Y gastric bypass: 10-year follow-up
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DOI：
10.1016/j.soard.2010.10.019
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发表时间：
2011-07-01
影响因子：
3.1
通讯作者：
Boone, Keith B.
中科院分区：
文献类型：
--
作者：
Higa, Kelvin;Ho, Tienchin;Boone, Keith B.
背景：减肥手术的短期益处已有充分的文献记载;然而，很少有超过10年的报告。那些已经发表的只描述了开放程序。我们提出了我们的10年随访结果与腹腔镜Roux-en-Y胃旁路与手工缝合胃空肠吻合术在一组私人practice.Methods：我们进行了一个机构审查委员会批准的回顾性审查的前瞻性维护的数据库，结合办公室访问和电话问卷调查，为患者谁接受了腹腔镜Roux-en-Y胃旁路术在1998年2月和1999年4月。1998年2月至1999年4月，共有242名患者接受了手术。2年和10年时的门诊随访率分别为33%和7%。另有19%的患者在10年时进行了电话随访。10年时平均体重减轻57%。在242名患者中，65名（33.2%）未能实现> 50%的过度体重减轻; 86名（35%）在随访期间发生>= 1例并发症。然而，分别有83%、87%、67%和76%的糖尿病、高血压、血脂异常和阻塞性睡眠呼吸暂停患者出现改善或消退。内疝发生率为16%，胃空肠狭窄发生率为4.9%。未发生手术相关死亡。在242例患者中，136例（51%）在术后1年后至少进行了一次营养检查。在这136例患者中，只有24（18%）在随访期间保持营养完整。结论：随访的障碍继续阻碍准确的长期数据的收集。在有数据的26%的患者中，腹腔镜Roux-en-Y胃旁路术提供了可持续的体重减轻和合并症的解决。然而，随着时间的推移，营养缺乏症偶尔出现，并强调了常规检测的重要性。(Surg肥胖相关疾病2011; 7：516-525。(C)2011年美国代谢和减肥外科学会。All rights reserved.
Background: The short-term benefits of bariatric surgery are well documented; however, few reports with data beyond 10 years exist. Those that have been published have described only open procedures. We present our 10-year follow-up results with laparoscopic Roux-en-Y gastric bypass with hand-sewn gastrojejunal anastomosis in a group private practice.Methods: We performed an institutional review board-approved retrospective review of a prospectively maintained database, combined with office visits and telephone questionnaires, for patients who underwent laparoscopic Roux-en-Y gastric bypass between February 1998 and April 1999.Results: A total of 242 patients underwent surgery from February 1998 to April 1999. The office follow-up rate was 33% at 2 years and 7% at 10 years. An additional 19% had telephone follow-up at 10 years. The mean excess weight loss was 57% at 10 years. Of the 242 patients, 65(33.2%) failed to achieve an excess weight loss of > 50%; 86 (35%) had >= 1 complication during follow-up. However, 83%, 87%, 67%, and 76% of patients with diabetes, hypertension, dyslipidemia, and obstructive sleep apnea, respectively, experienced improvement or resolution. The internal hernia rate was 16%, and the gastrojejunal stenosis rate was 4.9%. No surgery-related deaths occurred. Of the 242 patients, 136 (51%) had nutritional testing at least once after postoperative year 1. Of these 136 patients, only 24 (18%) had remained nutritionally intact during follow-up.Conclusion: The obstacles to follow-up have continued to impede the collection of accurate long-term data. Of the 26% of patients with data, laparoscopic Roux-en-Y gastric bypass provided sustainable weight loss and resolution of co-morbidities. However, nutritional deficiencies presented sporadically over time and underscore the importance of routine testing. (Surg Obes Relat Dis 2011; 7:516-525.) (C) 2011 American Society for Metabolic and Bariatric Surgery. All rights reserved.