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1.
Matar ZS 《Obesity surgery》2008,18(12):1632-1635
Laparoscopic adjustable gastric banding is a commonly performed bariatric operation worldwide. The presence of an anatomical
variation like situs inversus demands preoperative assessment and preparedness on the part of the surgeon. We report a laparoscopic
gastric banding performed on a morbidly obese patient with situs inversus totalis in the Kingdom of Saudi Arabia. 相似文献
2.
Laparoscopic adjustable gastric banding is a popular therapeutic option for morbid obesity. Band slippage, pouch enlargement
and esophageal dilatation are occasional late complications of this procedure. There are rare reports of recurrent aspiration
after banding. We report a 44-year-old female suffering from dysphagia and aspiration pneumonia 2 years after adjustable banding.
Her esophagus was dilated to 6 cm, and videocinematography showed a severe achalasia-like disorder.Withdrawal of fluid from
the band should be immediate, and relieved the stomal obstruction in this patient. Aspiration pneumonia is a serious late
complication, which is easily treated by deflation of the band. 相似文献
3.
Laparoscopic Adjustable Gastric Banding in 1,791 Consecutive Obese Patients: 12-Year Results 总被引:4,自引:0,他引:4
Favretti F Segato G Ashton D Busetto L De Luca M Mazza M Ceoloni A Banzato O Calo E Enzi G 《Obesity surgery》2007,17(2):168-175
Background This study examines 1,791 consecutive laparoscopic adjustable gastric banding (LAGB) procedures with up to 12 years follow-up.
Long-term results of LAGB with a high follow-up rate are not common.
Methods Between September 1993 and December 2005, 1,791 consecutive patients (75.1% women, mean age 38.7 years, mean weight 127.7 ± 24 kg,
mean BMI 46.2 ± 7.7) underwent LAGB by the same surgical team. Perigastric dissection was used in 77.8% of the patients, while
subsequently pars flaccida was used in 21.5% and a mixed approach in 0.8%. Data were analyzed according to co-morbidities,
conversion, shortand long-term complications and weight loss. Fluoroscopy-guided band adjustments were performed and patients
received intensive follow-up. The effects of LAGB on life expectancy were measured in a case/control study involving 821 surgically-treated
patients versus 821 treated by medical therapy.
Results Most common baseline co-morbidities (%) were hypertension (35.6), osteoarthritis (57.8), diabetes (22), dyslipidemia (27.1),
sleep apnea syndrome (31.4), depression (21.2), sweet eating (22.5) and binge eating (18.5). Conversion to open was 1.7%:
due to technical difficulties (1.2) and due to intraoperative complications (0.5).Together with the re-positioning of the
band, additional surgery was performed in 11.9% of the patients: hiatal hernia repair (2.4), cholecystectomy (7.8) and other
procedures (1.7). There was no mortality. Reoperation was required in 106 patients (5.9%): band removal 55 (3.7%), band repositioning
50 (2.7%), and other 1 (0.05%). Port-related complications occurred in 200 patietns (11.2%). 41 patients (2.3%) underwent
further surgery due to unsatisfactory results: removal of the band in 12 (0.7%), biliopancreatic diversion in 5 (0.27%) and
a biliopancreatic diversion with gastric preservation (“bandinaro”) in 24 (1.3%). Weight in kg was 103.7 ± 21.6, 102.5 ± 22.5,
105.0 ± 23.6, 106.8 ± 24.3, 103.3 ± 26.2 and 101.4 ± 27.1 at 1, 3, 5, 7, 9, 11 years after LAGB. BMI at the same intervals
was 37.7 ± 7.1, 37.2 ± 7.2, 38.1 ± 7.6, 38.5 ± 7.9, 37.5 ± 8.5 and 37.7 ± 9.1. The case/control study found a statistically
significant difference in survival in favor of the surgically-treated group.
Conclusions LAGB can achieve effective, safe and stable long-term weight loss. In experienced hands, the complication rate is low. Follow-up
is paramount.
Presented at the 11th World Congress of the International Federation for the Surgery of Obesity, Sydney, Australia, September
1, 2006. 相似文献
4.
Background: gastric banding has been performed for morbid obesity, with the last nine patients having a laparoscopic approach.
Materials: forty-five patients who had undergone primary operations for morbid obesity between 1986 and 1993 were selected
for retrospective analysis. All patients had undergone gastric banding. Average pre-operative BMI was 50.9 (kg m−2) and average pre-operative weight was 135.1 kg. Results: the 3-year mean post-operative BMI reached 28.7 and the 3-year mean
post-operative weight loss was 55.7 kg. Blood pressure significantly decreased from the mean 151/96 mmHg to 132/90 mmHg at
1-year follow-up. There were no significant changes noted in the levels of RBC, electrolytes and transaminase. There were
post-operative wound-healing complications in 18.1% of the patients, wound discharge in 8.8% and incisional hernia in 8.8%
of the patients. In 1993 we commenced laparoscopic gastric banding which enabled us to shorten the hospital stay and decrease
post-operative complications. Conclusion: we are achieving the same good weight-loss results with the laparoscopic technique
as after ‘open’ laparotomy gastric banding. 相似文献
5.
De Panfilis C Cero S Torre M Salvatore P Dall'Aglio E Adorni A Maggini C 《Obesity surgery》2007,17(6):792-799
Background The effectiveness of post-surgical weight loss in improving body image disturbance (BID) in morbidly obese patients is still
unclear. Providing multidimensional measures of BID and controlling for the effect of co-morbid eating psychopathology may
help to clarify this issue. This preliminary study explores whether 1) BID improves 1 year after laparoscopic adjustable gastric
banding (LAGB), and whether 2) such improvement is related to post-surgical BMI and/or eating disorder reduction. BID was
multidimensionally assessed by means of the Body Uneasiness Test(BUT).
Methods 35 obese subjects (mean BMI 45.5) were evaluated prior to and 1 year after LAGB using the BUT, and a standardized interview
and questionnaire to assess eating psychopathology. BID and eating habit changes during follow-up were also investigated.
Postoperative BUT values were entered as outcome measures (dependent variables) in a series of stepwise multiple regression
analyses; BMI and binge eating reduction, baseline BUT scores, gender, age, and age of onset of obesity were tested as independent
variables.
Results Some aspects of BID (body image overconcern and related avoidance behaviors, compulsive self-monitoring, and overall severity
of BID) improved following LAGB, while others (weight phobia, depersonalization, and uneasiness toward body parts) did not.
The post-surgical lower levels of the former were predicted by the overall decrease in binge eating symptoms, irrespective
of BMI reduction, age, gender, and age of onset of obesity.
Conclusions LAGB may ameliorate some BID aspects in morbidly obese patients, and an improvement in eating behaviors may contribute to
this effect. 相似文献
6.
Montgomery KF Watkins BM Ahroni JH Michaelson R Abrams RE Erlitz MD Scurlock JE 《Obesity surgery》2007,17(6):711-716
Background Laparoscopic adjustable gastric banding (LAGB) is a safe and effective treatment for morbid obesity that is well suited to
outpatient surgery. Super-obese patients (BMI ≥50) are often viewed as higher risk patients, with their surgical procedures
limited to hospital operating-rooms. We report our experience performing LAGB for super-obese patients in a freestanding ambulatory
surgery center and describe the program elements that make this feasible and safe.
Methods Database records containing 1,780 consecutive patients from program inception (November 2002 to November 2006) were searched
for patients with a BMI >49.9 undergoing an outpatient LAGB and reviewed to identify complications.
Results 320 super-obese patients underwent an outpatient LAGB.Mean preoperative weight was 155.2 kg (range 112.3–220.5 kg), and mean
BMI was 55.4 kg/m2 (range 50.0–71.1 kg/m2). 53 patients (16.6%) had BMI >60. There were no deaths, significant cardiopulmonary complications, significant intraoperative
bleeding, conversion to open laparotomy, or hospital admissions. 3 patients (0.1%) developed gastric edema causing transient
obstruction, and 1 developed a delayed colon perforation from electrocautery incurred during adhesiolysis. No complication
arose or was more difficult to manage as a result of the procedure being done on an outpatient basis.
Conclusions Outpatient LAGB can be safely performed in super-obese patients with a complication rate similar to lower BMI patients. Patient
selection and preoperative preparation are essential to achieve excellent outcomes. The decision to offer an outpatient LAGB
should rest on the overall physiological condition rather than BMI or weight alone. 相似文献
7.
A 20-year-old female, who had suffered from morbid obesity with a BMI of 41.2, was admitted 3 years after undergoing laparoscopic
gastric banding. 3 days before her present admission, she began suffering from abdominal pain without vomiting. On admission
investigation, gastric prolapse was diagnosed with complete obstruction of passage through the band. Emergency laparoscopy
was performed, which showed devitalization of the stomach above the band. At the operation, the band was removed, and conservative
treatment was begun with nasogastric aspiration, total parenteral nutrition, and close observation. 相似文献
8.
Bariatric Analysis and Reporting Outcome System (BAROS) Applied to Laparoscopic Gastric Banding Patients 总被引:3,自引:1,他引:3
Franco Favretti MD Guy Bernard Cadiere MD Gianni Segato MD Luca Busetto MD Andrea Loffredo MD Marc Vertruyen MD Giuliano Enzi MD Dorina Caniato MD Francesco De Marchi MD Mario Lise MD 《Obesity surgery》1998,8(5):500-504
Background: The definition of success and failure of a bariatric procedure should include weight loss as well as improvement
in comorbidity and quality of life assessment. The Bariatric Analysis and Reporting Outcome System (BAROS), introduced by
Oria and Moorhead in 1997, seems to provide a standard for comparison in the surgical treatment of morbid obesity. Methods:
180 morbidly obese and super-obese patients, who underwent laparoscopic gastric banding (lap-band) at our institutions and
had a follow-up > 18 months (19-55 months) were evaluated with BAROS. Results: The patients were divided into four outcome
groups (failure, fair, good, and excellent) based on a scoring table that adds or subtracts points while evaluating three
main areas: percentage of excess weight loss, changes in medical conditions, and assessment of quality of life. Points were
deducted for complications and reoperative surgery. Conclusions: The BAROS outcome system has proved to be a useful instrument
in evaluating midterm results in our series of lap-band patients. 相似文献
9.
Background The aim of this study is to examine the relationship between oxidative plasma protein and thiol stress and weight loss after
laparoscopic adjustable gastric banding (LAGB).
Methods Plasma protein carbonyl (PCO) concentration as a marker of protein oxidation, plasma thiol (PSH) and erythrocyte glutathione
concentration (GSH, major intracellular thiol), as an antioxidant and metabolic markers, such as Homeostatic Model Assessment
– Insulin resistance (HOMA-IR), BMI and plasma lipids were determined in morbidly obese patients (n 22, mean age 34.7 ± 11
years, BMI 48.4 ± 6.4 kg/m2) at baseline and 1 and 6 months after operation. Baseline levels in patients were also compared with the levels in agematched
controls (n 20, BMI 21.3 ± 1.8 kg/m2). Plasma PCO and thiols and erythrocyte GSH concentrations were determined spectrophotometrically.
Results Plasma PCO were significantly higher and plasma and erythrocyte thiol concentrations were significantly lower in morbidly
obese patients than in controls (for each comparison, P < 0.01). BMI, plasma triglycerides and HOMA-IR were positively correlated with plasma PCO and negatively correlated with
plasma P-SH and erythrocyte GSH (for each comparison, P < 0.01). Plasma HDL-cholesterol levels were positively correlated with plasma erythrocyte GSH (r = 0.405, P < 0.01) and negative correlated with plasma PCO (r = −0.273, P < 0.01). One and 6 months after the LAGB operation, total weight loss was 13.2 ± 6.3 and 35.5 ± 7.5 kg, respectively. Plasma
PCO concentrations were decreased and P-SH and erythrocyte GSH concentrations were elevated following weight loss (for each,
P < 0.01). Only plasma P-SH levels were restored to the control levels 6 months after LAGB.
Conclusions Obesity and insulin resistance appear to be associated with plasma protein oxidation and thiol concentrations. Protein and
thiol oxidative stress was improved by weight loss after LAGB in the short-term. 相似文献
10.
Pinar Cigdem Arica Seval Aydin Ulgen Zengin Ahmet Kocael Anil Orhan Kagan Zengin 《Journal of investigative surgery》2018,31(2):89-95
Background: The aim of this study was to examine the relationship between weight loss and resistin, apelin, chemerin, and visfatin after laparoscopic adjustable gastric banding (LAGB). Methods: The study group consisted of 19 patients who were operated on for morbid obesity (BMI: 48.7 ± 6.6 kg/m2), and 22 healthy, normal-weight (BMI: 22.9 ± 2.5 kg/m2) subjects formed the control group. We obtained blood samples from the study subjects at three different times: before undergoing surgery and at one month and 6 months after surgery. Blood was obtained once from the control group. Results: Significant weight loss was achieved at one and 6 months after surgery. Plasma levels of apelin, resistin, chemerin, and visfatin were higher in morbidly obese patients compared with the control group. Obesity-related peptides decreased one month and 6 months after surgery. Conclusions: Elevated plasma resistin, apelin, chemerin, and visfatin levels in morbidly obese patients are gradually reduced after weight loss. According to these findings, LAGB surgery is found to be an important and efficient means for morbidly obese patients both to lose weight and to develop a better metabolic risk profile in a short time period. 相似文献
11.
Anne Cardon MD Frido Berrevoet MD Piet Pattyn Uwe Hesse Bernard de Hemptinne 《Obesity surgery》1999,9(4):410-412
Background: Laparoscopic adjustable silicone gastric banding (LASGB) has become a widely used procedure for the treatment
of morbid obesity. The original operation, as described by Kuzmak, has been subjected to modifications. Construction of a
proximal gastric pouch is an important part of the operation. Until now, we used the technique of Niville. Since this was
often complicated by gastric bleeding and/or serosal tears, we developed a new technique to construct a pouch. Surgical Technique:
A new technique, using a thread previously fixed to that portion of the fundus that will be used to construct the pouch, is
described. Conclusion: A safe and easy adaptation of the LASGB technique is proposed to create the gastric pouch. 相似文献
12.
Cossu ML Caccia S Coppola M Fais E Ruggiu M Fracasso C Nacca A Noya G 《Obesity surgery》1999,9(1):36-39
Background: Patients undergoing biliopancreatic diversion (BPD) may develop gastric ulcers, particularly within the first
postoperative year. The prophylactic use of antisecretory compounds at the usual therapeutic doses, mainly conventional H2-receptor antagonists such as ranitidine, may reduce the incidence of this complication, which occurs in ∼5% of patients after
BPD. Methods: The authors measured the plasma concentrations of ranitidine (300 mg orally) in obese patients, before and 8
months after BPD, and in control subjects of normal weight. The study included 11 obese patients undergoing BPD (age 45 ±
14 years; preoperative and postoperative weights 124 ± 21 and 92 ± 11 kg) and 10 normal-weight subjects (age 37 ± 13 years,
weight 67 ± 9 kg). Results: Postoperative ranitidine plasma concentrations showed only minor differences from preoperative
levels, with slightly higher maximum concentrations occurring sooner. The mean area under the curve was on the average 30%
higher than preoperatively. All parameters, however, were similar to those in control subjects. Conclusions: BPD per se does
not greatly affect the pharmacokinetic behavior of ranitidine, and therefore a conventional dosage regimen appears adequate
for the prophylaxis and therapy of gastric ulcers associated with this operation. 相似文献
13.
Background The authors evaluated the impact of laparoscopic adjustable gastric banding (LAGB) on obesity-associated diseases in a series
at 3 to 8 years postoperatively, namely diabetes, pulmonary disease, hypertension and knee joint pain.
Methods 145 morbidly obese patients underwent LAGB with mean age 38 years and preoperative BMI 48.5 kg/m2 (range 34–77). Changes in
BMI and excess BMI loss (EBL) were evaluated.
Results 138 of the 145 patients (95%) were available for full follow-up. At last follow-up, BMI had dropped to 34.0 ± 6.4 SD kg/m2, and mean EBL was 61.9 ± 26.1%. Prevalence of obesity-associated disease was significantly reduced: diabetes decreased from
10% to 4%, treatment-requiring pulmonary disease from 15% to 5%, hypertension from 43% to 27%, and knee pain from 47% to 38%.
Conclusion Following gastric banding, >75% of patients suffering from obesity-related disease had significant decrease or resolution
of their co-morbidities. 相似文献
14.
Lise M Favretti F Belluco C Segato G De Marchi F Foletto M Enzi G Busetto L 《Obesity surgery》1994,4(3):274-278
From April 1990 through December 1992, 111 patients (80 females, 31 males, mean age 38 years, range 16-60) underwent stoma
adjustable silicone gastric banding (SASGB) at the Department of Surgery, University Hospital, Padua, Italy. Patients' characteristics
were: mean height 166 ± 8 cm; mean body weight (BW) 129.1 ± 21.6 kg; mean body mass index (BMI) 46.4 ± 6.3 kg/m2; mean percentage of ideal body weight (%IBW) 206.2 ± 27. Eighty-eight patients were morbidly obese and 23 super obese. All
patients were available for follow-up. Median follow-up was 18.8 months (range 12-44). At 1 year (103 patients), mean postoperative
BW, BMI, %IBW and excess weight lost (%EWL) were 101.5 ± 20 kg, 36.5 ± 6 kg/m2, 164 ± 30 and 40.8 ± 19 respectively; at 2 years (58 patients) 92.3 ± 19 kg, 33.1 ± 6 kg/m2, 148.8 ± 28, 52 ± 23, respectively, and at 3 years (26 patients) 86.9 ± 14 kg, 31.4 ± 5 kg/m2, 141.5 ± 25 and 63.6 ± 20 respectively. The overall postoperative mortality rate was zero and the early morbidity rate 9%.
Late complications were band slippage (two patients), stoma stenosis with pouch dilatation (seven patients), band erosion
(one patient), reservoir leakage (three patients) and reservoir infection (two patients). Surgical revision was performed
in ten (9%) patients, two of whom required band removal. Most complications occurred in patients who underwent SASGB during
our initial experience. Our findings confirm that SASGB is a safe and effective surgical means of achieving weight reduction. 相似文献
15.
Late Pouch Dilation after Laparoscopic Adjustable Gastric and Esophagogastric Banding: Incidence, Treatment, and Outcome 总被引:4,自引:1,他引:3
Background: Pathologic late pouch dilation is the most frequent complication following gastric banding procedures for morbid
obesity. In this study, possible predictive factors were sought. The treatment of these complications and the final outcome
are discussed. Methods: Between December 1994 and December 1997, 171 patients underwent laparoscopic adjustable banding for
morbid obesity. 40 patients underwent classic gastric banding (Group 1), and 131 patients underwent esophagogastric banding
(Group 2). Results: Pouch dilation developed in 6 patients (15%) in Group 1 and 12 patients (9.2%) in Group 2. There were
no significant predictive factors, although the complication occurred more frequently in patients with presurgical hiatus
hernia. The type of dilation was different for each group, as was the surgical treatment. Laparoscopic repositioning of the
band was always possible and was uncomplicated. The long-term outcome has been good, and weight loss has been maintained.
Conclusions: A frequent complication following banding procedures for morbid obesity is pathologic late pouch dilation. In
experienced hands, when appropriate surgical treatment is carried out, this is not a major problem. Nevertheless, efforts
should be made to decrease the number of late dilations. 相似文献
16.
DiGiorgi M Daud A Inabnet WB Schrope B Urban-Skuro M Restuccia N Bessler M 《Obesity surgery》2008,18(9):1144-1148
BACKGROUND: Several studies have suggested that morbid obesity is associated with vitamin D deficiency and elevated parathyroid hormone (PTH). Studies have also suggested that there is an increase in vitamin D deficiency, bone resorption, and elevated PTH after gastric bypass surgery. Few studies have evaluated markers of bone and calcium metabolism after laparoscopic adjustable gastric banding or compared these results to those after gastric bypass. METHODS: Data on all patients undergoing primary gastric bypass (GBP; n = 979) and laparoscopic adjustable gastric banding (LAGB; n = 269) procedures at a tertiary-referral center from June 1996 through March 2005 were reviewed from a prospective database. Only patients with 25OH vitamin D levels available were included in this study (n = 534; GBP = 403, LAGB = 131). All patients were advised to take at least 1,200 mg calcium and 800-1,200 IU of vitamin D daily before and subsequent to their operation. Markers for bone metabolism [25OH Vitamin D, corrected serum calcium, alkaline phosphatase (AP), and PTH] were evaluated preoperatively and 3, 6, 12, and 24 months postoperatively. An analysis of variance and chi-square were performed to determine differences between the operative groups. Linear regression analysis was performed to evaluate the relationship between preoperative body mass index (BMI) and 25OH vitamin D and PTH levels and between percent excess weight loss and 25OH vitamin D and PTH after surgery. RESULTS: Sixty-four percent of all patients presented with vitamin D deficiency (<20 ng/ml) and 14% presented with elevated PTH preoperatively. Mean 25OH vitamin D levels and AP levels increased significantly after GBP surgery (vitamin D, 17 to 25 ng/ml 12 months post-op; AP, 80 to 90 IU/L 24 months post-op). Corrected calcium levels remained within normal limits and showed no change over time after both procedures. AP levels significantly increased from 76 IU/l preoperatively to 82 IU/l 6 months after LAGB surgery and then decreased to 59 IU/l 24 months after LAGB surgery. Linear regression analysis of preoperative vitamin D, PTH, and BMI values showed a significant positive relationship between initial BMI and PTH (r = 0.29) and a significant negative relationship between vitamin D and initial BMI (r = -0.19). A significant positive linear relationship between vitamin D and percent excess weight loss was evident 12 and 24 months after GBP surgery (r = 0.39 and 0.57, respectively). A negative relationship was evident between PTH and vitamin D 6 months after GBP surgery (r = -0.35) and 12 months after LAGB surgery (r = -0.61). CONCLUSIONS: These findings suggest that morbid obesity is associated with vitamin D deficiency, and elevated PTH and with adequate supplementation, GBP, and particularly LAGB, patients can improve their bone metabolism abnormalities related to obesity. Furthermore, adequate supplementation for GBP patients may attenuate the increased risk for bone loss associated with malabsorption from the bypass. 相似文献
17.
Favretti F Cadiere GB Segato G Bruyns G De Marchi F Himpens J Foletto M Lise M 《Obesity surgery》1995,5(4):364-371
Background: Kuzmak's Adjustable Silicone Gastric Banding (ASGB) is the least invasive operation available for morbid obesity,
and it is one of the more effective. Based on the know-how gained from performing more than 250 ‘open’ procedures, we have
developed an original laparoscopic technique, whose main steps are pouch measurement, limited dissection along the lesser
and the greater curvature and the application of the retention sutures. Methods: From September 1993 through October 1994,
30 morbidly obese patients underwent laparoscopic ASGB. Results: Mean operative time was 2 h and the post-operative stay 2-3
days. Only one major perioperative complication (stomach slippage) was observed. The weight loss achieved, reported as a variation
of Body Weight, Body Mass Index, per cent Ideal Body Weight and per cent Excess Weight Loss was similar to that obtained with
the open procedure. Conclusion: This new approach is a major achievement in bariatric surgery, because it combines the minimal
invasiveness of laparoscopy with the reversibility and adjustability of ASGB. 相似文献
18.
Renata Ramalho Cristina Guimarães Cidália Gil Celestino Neves João Tiago Guimarães Luís Delgado 《Obesity surgery》2009,19(7):915-920
Background Inflammatory status underlying obesity seems to be implicated in several aspects of metabolic syndrome.
Objective This study aimed to investigate the association between weight loss achieved by laparoscopic gastric banding (LAGB) surgery,
chronic inflammatory markers, and nutritional state.
Methods Thirty-two morbid obese females were enrolled in the study and evaluated at baseline, 1 and 18 months after LAGB surgery.
Serum immunoglobulin G (IgG), IgA, IgM, C-reactive protein (CRP), haptoglobin, alpha-1 antitrypsin, total proteins, albumin,
prealbumin, transferrin, ferritin, and transferrin soluble receptor were evaluated. In addition, total cholesterol, low-density
lipoprotein cholesterol, high-density lipoprotein cholesterol, and fasting glucose were also evaluated.
Results In average, patients presented 18.7% and 63.2% excess body weight loss 1 and 18 months after LAGB, respectively (p < 0.01). CRP and total cholesterol mean levels were elevated (1.03 ± 1.11 mg dL−1 and 2.02 ± 0.41 g L−1) at the presurgery study. CRP mean levels were significantly reduced when compared to reference range (p < 0.01) 18 months after the LAGB surgery. Prealbumin as well as serum total protein mean levels decreased 1 month after surgery
(p < 0.01) and values returned to normal at 18 months after surgery. Albumin mean levels showed an increase during the postsurgery
evaluations. Serum IgA and IgM concentrations were significantly increased at 1 month after surgery compared to baseline (p < 0.01, both cases).
Conclusions Our results indicate that amelioration of inflammatory markers after LAGB does not seem to negatively impact nutritional status
following weight reduction surgery. However, careful attention should be driven to serum IgA. Adequacy of nutritional intake
and complete serial laboratory measurements should be always included in the required life-long follow-up of patients surgically
treated for morbid obesity. 相似文献
19.
Assessment of the Outcome of Laparoscopic Nonadjustable Gastric Banding and Stoma Adjustable Gastric Banding: Surgeon's and Patient's View 总被引:1,自引:0,他引:1
Background: The results of nonadjustable gastric banding (NAGB) and stoma adjustable gastric banding (SAGB) in the treatment
of morbid obesity are compared. Of 300 patients operated laparoscopically with NAGB since 1993 and of 25 with SAGB since 1994,
65 in the NAGB and 11 in the SAGB group were available for a 3-year follow-up study. Methods: For assessment of the outcome
of our laparoscopic approach in terms of weight loss, length of hospitalization, immediate and late postoperative wound complications,
postoperative changes in the band and pouch area, were compared in patients from both groups. The patient's opinion on the
outcome of the operation and the quality of postoperative digestion was recorded. Results: There was no significant difference
in the length of hospital stay and wound complication rate in the two groups or the weight loss at 36 months after surgery.
There was a statistically significant lower incidence of postoperative food intolerance and vomiting and a lower rate of immediate
and long-term reoperation rate in the SAGB group. Conclusion: SAGB is a method with less postoperative complications in food
intolerance and vomiting in comparison with NAGB. 相似文献
20.
Results and Complications of Laparoscopic Adjustable Gastric Banding: An Early and Intermediate Experience 总被引:4,自引:0,他引:4
Background: Laparoscopic adjustable silicone gastric banding (LASGB) has been performed as the initial procedure for weight
reduction in the authors' institution for the past 22 months. The efficacy and safety of the procedure were studied. Methods:
Patients were followed up prospectively during the perioperative and long-term course and for complications. Results: 391
patients, aged 16-72 years, with a mean body mass index (BMI) of 43.1 (range 33-66) were operated on. The laparoscopic procedure
was completed in all but four. The mean operative time was 78 min (range 36-165), and the mean postoperative hospital stay
was 1.2 days (range 1-8). There were four (1%) intraoperative complications: pneumothorax in one patient, bleeding in two
patients, and injury to the stomach in one. Early postoperative complications were subphrenic abscess in two patients and
band malposition in five. Of the patients operated on, 356 (91%) were available for follow-up. Over an average follow-up period
of 13 months (range 1-22), band slippage occurred in 16 patients (4.1%), resistant port infection in 1, and longstanding pain
in the port area in 9. There were 2 cases of port migration. A total of 26 (6.4%) reoperations were performed: early band
repositioning (5), bleeding port site (1), late band repositioning (13), band removal (5), and local relocation of the port
(2). All abdominal operations were performed laparoscopically. During the 18-month follow-up, the average BMI dropped from
43.1 to 29.8. Conclusion: LASGB is a safe procedure, with low early complication rates. Most reoperations may be performed
laparoscopically, with subsequent low morbidity and short hospitalizations. On intermediate-term follow-up it seems to be
an effective bariatric procedure. 相似文献