腹腔镜一次吻合胃旁路术作为垂直带状胃成形术失败后的修补手术:我们中心的经验。

IF 3.8 Q2 ENDOCRINOLOGY & METABOLISM
Journal of Obesity Pub Date : 2025-03-30 eCollection Date: 2025-01-01 DOI:10.1155/jobe/4161005
Hosam Elghadban, Ashraf Shoma, Emad Abdallah, Ahmed Negm, Elsayed Abdullah, Hossam Hamed, Sameh Ghareeb, Ahmed Lotfy, Ahmed Taki-Eldin
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引用次数: 0

摘要

背景:垂直带状胃成形术(VBG)历来是一种流行的限制性减肥手术,但由于体重反弹、狭窄和胃食管反流导致的长期失败率使得修正干预成为必要。一吻合术胃旁路术(OAGB),也被称为微型胃旁路术,由于其技术简单,并发症发生率低,代谢结果良好,已成为一种可行的修复选择。本研究基于本中心的经验和对当前文献的回顾,评估了OAGB作为VBG失败后的修复程序的安全性、有效性和结果。方法:回顾性研究了2014年2月至2020年2月间71例开放性VBG失败后行OAGB修补术的患者。评估有关体重减轻(超重体重减轻百分比(EBWL %)和体重指数(BMI)变化)、合并症缓解、发病率和死亡率的三年结果。结果:术后1年、2年、3年EBWL %分别为68.2±9.4%、65.9±2.5%、59.6±7.4%。术前BMI均值为41.8±3.7 kg/m2,术后3年BMI均值降至31.9±4.2 kg/m2。1年后,肥胖相关的合并症显著缓解,2型糖尿病缓解率为85.7%,高血压缓解率为80%。其他合并症的缓解也被观察到。胆汁反流6例(8.5%),其中2例需要手术治疗。结论:OAGB是一种可行、有效的VBG切开失败后的修复方法。然而,应该考虑胆汁反流的风险来证明这些发现的合理性;需要进一步的前瞻性随机对照试验。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Laparoscopic One Anastomosis Gastric Bypass as a Revisional Procedure After Failed Vertical Banded Gastroplasty: Our Center Experience.

Background: Vertical banded gastroplasty (VBG) was historically a popular restrictive bariatric procedure, but long-term failure rates due to weight regain, stenosis, and gastroesophageal reflux have necessitated revisional interventions. One anastomosis gastric bypass (OAGB), also known as mini-gastric bypass, has emerged as a viable revisional option due to its technical simplicity, lower complication rates, and promising metabolic outcomes. This study evaluates the safety, efficacy, and outcomes of OAGB as a revisional procedure following failed VBG, based on our center's experience and a review of the current literature. Methods: Seventy-one patients who underwent revisional OAGB after failed open VBG between February 2014 and February 2020 were included in this retrospective study. Three years outcomes regarding weight loss (the percentage of excess body weight loss (EBWL %) and change in body mass index (BMI)), co-morbidities resolution, morbidity, and mortality were assessed. Results: The EBWL % after revisional OAGB was 68.2 ± 9.4%, 65.9 ± 2.5%, and 59.6 ± 7.4% after 1, 2, and 3 years, respectively. The mean BMI before revisional surgery was 41.8 ± 3.7 kg/m2,which decreased to 31.9 ± 4.2 kg/m2 3 years after the revisional surgery. After 1 year, there was a remarkable resolution of obesity-related co-morbidities, the remission of type 2 diabetes mellitus was 85.7%, and of hypertension was 80%. Remission of other comorbidities was also observed. Bile reflux was encountered in 6 cases (8.5%), two of them required surgical intervention. Conclusions: OAGB is a feasible and effective revisional procedure after failed open VBG. However, the risk of bile reflux should be considered to justify these findings; further prospective randomized controlled trials are required.

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来源期刊
Journal of Obesity
Journal of Obesity ENDOCRINOLOGY & METABOLISM-
CiteScore
7.50
自引率
3.00%
发文量
19
审稿时长
21 weeks
期刊介绍: Journal of Obesity is a peer-reviewed, Open Access journal that provides a multidisciplinary forum for basic and clinical research as well as applied studies in the areas of adipocyte biology & physiology, lipid metabolism, metabolic syndrome, diabetes, paediatric obesity, genetics, behavioural epidemiology, nutrition & eating disorders, exercise & human physiology, weight control and health risks associated with obesity.
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