背景:Roux-en-Y胃旁路术(RYGB)被认为是肥胖患者最有效的治疗方法之一。此程序的一种变体,带状RYGB,可以呈现优于标准技术的几个优点。这些潜在的好处包括增强体重减轻,减少经常性体重增加,倾倒综合征的发病率较低,胃空肠造口术下空肠扩张较少。
目的:本荟萃分析的目的是比较RYGB手术与带(带状-RYGB)和不带带(RYGB)手术治疗肥胖患者的结果。
方法:根据系统评价和荟萃分析指南的首选报告项目和Cochrane方案(PROSPEROID:CRD42023439874)进行系统评价和荟萃分析。
方法:系统评价过程确定了13项比较研究,涉及3230名接受带状RYGB的患者和5302名接受RYGB的患者,所有这些都符合纳入和荟萃分析的条件.
结果:四项研究报告了术后1年超重百分比(%EWL)的数据,在接受带状RYGB的患者中,EWL显着增加6.03%。四项研究报告了2年术后%EWL,显示与接受RYGB的患者相比,接受过带状RYGB的患者的EWL高出5.32%,即使这没有统计学意义。对于减肥手术后5年的EWL%,纳入5项研究进行连续结局荟萃分析。平均5年EWL%差异为7.6,有利于带状RYGB。与接受RYGB的患者相比,患有带状RYGB的患者出现术后并发症的OR为1.45。
结论:这项荟萃分析表明,与RYGB相比,行带状化-RYGB手术的患者在术后1,2和5年的EWL%有统计学意义的增加.此外,绑扎手术不会显著增加术后并发症的风险.
BACKGROUND: The Roux-en-Y gastric bypass (RYGB) is considered as one of the most effective treatments for people with obesity. A variant of this procedure, the banded-RYGB, may present several advantages over the standard technique. These potential benefits include enhanced weight loss, decreased recurrent weight gain, a lower incidence of dumping syndrome, and less distention of the jejunum below the gastrojejunostomy.
OBJECTIVE: The objective of this meta-analysis is to compare the surgical outcomes of RYGB procedures with a band (banded-RYGB) and without a band (RYGB) in the management of individuals with obesity.
METHODS: A systematic
review and meta-analysis was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and the Cochrane protocol (PROSPERO ID: CRD42023439874).
METHODS: The systematic
review process led to the identification of 13 comparative studies involving 3230 patients who underwent banded-RYGB and 5302 who received RYGB, all of which were eligible for inclusion and meta-analysis.
RESULTS: Four studies reported data on 1-year postoperative percent excess weight loss (%EWL), demonstrating a significant increase of 6.03 %EWL in patients who underwent banded-RYGB. Four studies reported the 2-year postoperative %EWL, showing that patients who had banded-RYGB experienced a 5.32 greater %EWL compared to those who received RYGB, even if this was not statistically significant. For 5-year %EWL after bariatric surgery, 5 studies were included for continuous outcome meta-analysis. The average 5-years %EWL difference was 7.6 in favor of banded-RYGB. Patients who had banded-RYGB presented a nonsignificant 1.45 OR of developing postoperative complications compared to patients receiving RYGB.
CONCLUSIONS: This meta-analysis demonstrates that, compared to RYGB, patients who underwent banded-RYGB surgery showed a statistically significant increase in the %EWL at 1, 2, and 5 years postoperatively. Moreover, the banding procedure does not significantly increase the risk of postoperative complications.