PDF(Pubmed)
Abstract：
UNASSIGNED: Comparative data on long-term outcomes of mechanistically different bariatric operations are scarce.
UNASSIGNED: In this prospective, observational study, consecutive patients with severe obesity were studied using a predefined reoperation algorithm to determine long-term health outcomes after bariatric surgery (BS): adjustable gastric banding (AGB), Roux-en-Y gastric bypass (RYGB), or biliopancreatic diversion (BPD). All patients were assessed for mortality, postoperative weight loss, rate of reoperation, comorbidities, and quality of life (QoL) 8 years after surgery.
UNASSIGNED: Between 1996 and 2008, 2364 Swiss patients, with a mean body mass index of 43 ± 7 kg/m2 (mean ± SD) underwent AGB (n = 1404), RYGB (n = 790), or BPD (n = 170). Two thousand two hundred twenty-eight (94%) were followed for 8 years after BS. Eight-year mortality of the whole study group was 34.3 per 104 person-years. Percent excessive weight loss at 8 years was 56.7 ± 1.4% (95% confidence interval) in AGB, 62.5 ± 2.4% in RYGB and 64.8+-3.0% in BPD. The rate of major reoperation was highest in AGB and significantly lower in RYGB and BPD (63.4 vs 54.3 vs 47.2 per 103 person-years, P < 0.001). Remission of comorbidities was observed across all 3 groups, with key improvement (P < 0.01) in esophagitis in the RYGB group, and type 2 diabetes (T2D) (>60%) in procedures involving duodenal exclusion. Total improvement in QoL was similar between the 3 types of operations but was strongly correlated with weight loss preservation (P < 0.001).
UNASSIGNED: BS, at the expense of a high reoperation rate but low procedural mortality, considerably improves the QoL and results in sustained remission of comorbidities, especially T2D using a predefined reoperation algorithm developed to prevent weight regain and operation-specific complications.
UNASSIGNED: In this prospective, observational study, consecutive patients with severe obesity were studied using a predefined reoperation algorithm to determine long-term health outcomes after bariatric surgery (BS): adjustable gastric banding (AGB), Roux-en-Y gastric bypass (RYGB), or biliopancreatic diversion (BPD). All patients were assessed for mortality, postoperative weight loss, rate of reoperation, comorbidities, and quality of life (QoL) 8 years after surgery.
UNASSIGNED: Between 1996 and 2008, 2364 Swiss patients, with a mean body mass index of 43 ± 7 kg/m2 (mean ± SD) underwent AGB (n = 1404), RYGB (n = 790), or BPD (n = 170). Two thousand two hundred twenty-eight (94%) were followed for 8 years after BS. Eight-year mortality of the whole study group was 34.3 per 104 person-years. Percent excessive weight loss at 8 years was 56.7 ± 1.4% (95% confidence interval) in AGB, 62.5 ± 2.4% in RYGB and 64.8+-3.0% in BPD. The rate of major reoperation was highest in AGB and significantly lower in RYGB and BPD (63.4 vs 54.3 vs 47.2 per 103 person-years, P < 0.001). Remission of comorbidities was observed across all 3 groups, with key improvement (P < 0.01) in esophagitis in the RYGB group, and type 2 diabetes (T2D) (>60%) in procedures involving duodenal exclusion. Total improvement in QoL was similar between the 3 types of operations but was strongly correlated with weight loss preservation (P < 0.001).
UNASSIGNED: BS, at the expense of a high reoperation rate but low procedural mortality, considerably improves the QoL and results in sustained remission of comorbidities, especially T2D using a predefined reoperation algorithm developed to prevent weight regain and operation-specific complications.
摘要：
■关于机械上不同的减肥手术的长期结果的比较数据很少。
■在这个前景中，观察性研究，使用预定义的再手术算法对重度肥胖的连续患者进行研究，以确定减肥手术（BS）后的长期健康结果：可调节胃束带（AGB），Roux-en-Y胃旁路术(RYGB),或胆胰分流（BPD）。对所有患者进行死亡率评估，术后体重减轻，再手术率,合并症,术后8年的生活质量(QoL)。
■1996年至2008年间，2364名瑞士患者，平均体重指数为43±7kg/m2（平均值±SD），接受AGB（n=1404），RYGB（n=790），或BPD（n=170）。在BS治疗后的8年中，追踪了2,200,28（94％）。整个研究组的八年死亡率为34.3/104人年。在AGB中，8年的过度体重减轻百分比为56.7±1.4％（95％置信区间），RYGB为62.5±2.4%，BPD为64.8+-3.0%。AGB的主要再手术率最高，RYGB和BPD的再手术率明显较低（每103人年63.4vs54.3vs47.2，P<0.001)。在所有3组中观察到合并症的缓解，RYGB组食管炎有明显改善(P<0.01),和2型糖尿病（T2D）（>60％）在涉及十二指肠排斥的程序。3种手术的总QoL改善相似，但与体重减轻密切相关（P<0.001）。
■BS,以高的再手术率但低的手术死亡率为代价，大大提高了QoL，并导致合并症的持续缓解，特别是使用预定义的再手术算法开发的T2D，以防止体重恢复和手术特定的并发症。
■在这个前景中，观察性研究，使用预定义的再手术算法对重度肥胖的连续患者进行研究，以确定减肥手术（BS）后的长期健康结果：可调节胃束带（AGB），Roux-en-Y胃旁路术(RYGB),或胆胰分流（BPD）。对所有患者进行死亡率评估，术后体重减轻，再手术率,合并症,术后8年的生活质量(QoL)。
■1996年至2008年间，2364名瑞士患者，平均体重指数为43±7kg/m2（平均值±SD），接受AGB（n=1404），RYGB（n=790），或BPD（n=170）。在BS治疗后的8年中，追踪了2,200,28（94％）。整个研究组的八年死亡率为34.3/104人年。在AGB中，8年的过度体重减轻百分比为56.7±1.4％（95％置信区间），RYGB为62.5±2.4%，BPD为64.8+-3.0%。AGB的主要再手术率最高，RYGB和BPD的再手术率明显较低（每103人年63.4vs54.3vs47.2，P<0.001)。在所有3组中观察到合并症的缓解，RYGB组食管炎有明显改善(P<0.01),和2型糖尿病（T2D）（>60％）在涉及十二指肠排斥的程序。3种手术的总QoL改善相似，但与体重减轻密切相关（P<0.001）。
■BS,以高的再手术率但低的手术死亡率为代价，大大提高了QoL，并导致合并症的持续缓解，特别是使用预定义的再手术算法开发的T2D，以防止体重恢复和手术特定的并发症。
