PDF(Pubmed)
Abstract：
Laparoscopic adjustable gastric band (LAGB) has high technical and weight loss failure rates. We evaluate here the 1-year morbidity, mortality, and weight loss of laparoscopic Roux-en-Y-gastric bypass (LRYGB) as a feasible conversion strategy.
Patients with a failed primary LAGB who underwent LRYGB from July 2004 to December 2019 were selected from an electronic database at our center. Patients had a conversion to LRYGB at the same time (one-stage approach) or with a minimum of 3 months in between (two-stage approach). Primary outcomes included 30-day morbidity and mortality. Secondary outcomes were body mass index (BMI), percent excess weight loss (%EWL), and percent excess BMI lost (%EBMIL) at 1 year postoperatively.
A total of 1295 patients underwent a conversion from LAGB to LRYGB at our center: 1167 patients (90.1%) in one stage and 128 patients (9.9%) in two stages. There was no mortality. An early (30-day) postoperative complication occurred in 93 patients (7.2%), with no significant difference found between groups. Hemorrhage was the most common complication in 39 patients (3.0%), and the reoperation was required in 19 patients (1.4%). At 1 year postoperatively, the mean BMI was 28.0 kg/m2, the mean %EWL 72.8%, and the mean %EBMIL 87.0%. No statistically significant difference was found between the groups.
Conversion to LRYGB can be considered as a safe and effective option with low complication rate and good weight loss outcomes at 1 year. One-stage conversion provides the same early outcome as two-step surgery with a competent surgeon.
Patients with a failed primary LAGB who underwent LRYGB from July 2004 to December 2019 were selected from an electronic database at our center. Patients had a conversion to LRYGB at the same time (one-stage approach) or with a minimum of 3 months in between (two-stage approach). Primary outcomes included 30-day morbidity and mortality. Secondary outcomes were body mass index (BMI), percent excess weight loss (%EWL), and percent excess BMI lost (%EBMIL) at 1 year postoperatively.
A total of 1295 patients underwent a conversion from LAGB to LRYGB at our center: 1167 patients (90.1%) in one stage and 128 patients (9.9%) in two stages. There was no mortality. An early (30-day) postoperative complication occurred in 93 patients (7.2%), with no significant difference found between groups. Hemorrhage was the most common complication in 39 patients (3.0%), and the reoperation was required in 19 patients (1.4%). At 1 year postoperatively, the mean BMI was 28.0 kg/m2, the mean %EWL 72.8%, and the mean %EBMIL 87.0%. No statistically significant difference was found between the groups.
Conversion to LRYGB can be considered as a safe and effective option with low complication rate and good weight loss outcomes at 1 year. One-stage conversion provides the same early outcome as two-step surgery with a competent surgeon.
摘要：
目的：腹腔镜可调节胃束带（LAGB）具有较高的技术和体重减轻失败率。我们在这里评估1年发病率，死亡率,和减重腹腔镜下Roux-en-Y-胃旁路术（LRYGB）作为一种可行的转换策略。
方法：从我们中心的电子数据库中选择2004年7月至2019年12月接受LRYGB的原发性LAGB失败患者。患者同时(一阶段方法)或其间至少3个月(两阶段方法)转换为LRYGB。主要结果包括30天发病率和死亡率。次要结果是体重指数（BMI），过量体重减轻百分比(%EWL)，以及术后1年超重体重指数丢失百分比(%EBMIL)。
结果：我们中心共有1295名患者从LAGB转换为LRYGB：一个阶段有1167名患者（90.1%），两个阶段有128名患者（9.9%）。没有死亡。术后早期（30天）并发症发生在93例（7.2%），组间无显著差异。出血是39例患者中最常见的并发症（3.0%），19例患者(1.4%)需要再次手术。术后1年，平均BMI为28.0kg/m2，平均%EWL为72.8%，和平均%EBMIL87.0%。组间无统计学差异。
结论：转用LRYGB可以被认为是一种安全有效的选择，在1年时并发症发生率低，体重减轻效果好。一阶段转换提供与合格外科医生的两步手术相同的早期结果。
方法：从我们中心的电子数据库中选择2004年7月至2019年12月接受LRYGB的原发性LAGB失败患者。患者同时(一阶段方法)或其间至少3个月(两阶段方法)转换为LRYGB。主要结果包括30天发病率和死亡率。次要结果是体重指数（BMI），过量体重减轻百分比(%EWL)，以及术后1年超重体重指数丢失百分比(%EBMIL)。
结果：我们中心共有1295名患者从LAGB转换为LRYGB：一个阶段有1167名患者（90.1%），两个阶段有128名患者（9.9%）。没有死亡。术后早期（30天）并发症发生在93例（7.2%），组间无显著差异。出血是39例患者中最常见的并发症（3.0%），19例患者(1.4%)需要再次手术。术后1年，平均BMI为28.0kg/m2，平均%EWL为72.8%，和平均%EBMIL87.0%。组间无统计学差异。
结论：转用LRYGB可以被认为是一种安全有效的选择，在1年时并发症发生率低，体重减轻效果好。一阶段转换提供与合格外科医生的两步手术相同的早期结果。
