15ο Παγκόσμιο Συνέδριο Χειρουργικής Παχυσαρκίας και των Μεταβολικών Νοσημάτων (IFSO 2010) Los Angeles - California, 3-7 Σεπτεμβρίου 2010
Από 3 ως 7 Σεπτεμβρίου 2010 πραγματοποιήθηκε στο Los Angeles των Ηνωμένων Πολιτειών το 15ο Παγκόσμιο Συνέδριο Χειρουργικής της Νοσογόνου Παχυσαρκίας και των Μεταβολικών Νοσημάτων (IFSO 2010).
Στο Συνέδριο παρουσιάστηκε η εμπειρία μας από 1582 ασθενείς με 6 έτη παρακολούθησης καθώς επίσης και η ιδιαίτερη αποτελεσματικότητα του γαστρικού δακτυλίου σε παχύσαρκους ασθενείς με χαμηλό Δείκτη Μαζας Σωματος(ΒΜΙ)
Περιλήψεις
1. SIX YEARS EXPERIENCE WITH ADJUSTABLE GASTRIC BAND. ANALYSIS OF 1582 CASES – 41 TONNES WEIGHT LOSS
BACKGROUND: The aim of this study was to determine the long-term results of LAGB in a series of 1582 patients with high follow-up rate, all operated by one surgeon.
METHODS: Between April 2004 and February 2010, 1582 patients have undergone LAGB in a single center using the Helioscopie band (Heliogast® HAGE). The pars-flaccida technique was used and close follow-up was achieved in 96.6% of patients. Mean follow-up was 37±13 months, range 12-70. Complication rate and weight loss have been prospectively recorded.
RESULTS: The mean age of patients was 37±11 years (range 15-70), mean weight 130±28 kgs (range 87-265) and mean BMI 45± 7(range 30-75). The mean hospital stay was 24 hrs, 2.7% of patients were discharged home the same day. There was 1 mortality (0.06%) from massive pulmonary embolism 22 days postoperatively. Early complications were found in 4 patients (2 cases of bleeding, 2 cases of stoma obstruction). All 4 cases required reoperation. Late complications comprised slippage in 64 patients (4.3%), erosion 15(1%) and band infection in 3 patients (0.18%). Mean excess weight loss was 49%, 60%, 65%, 65%, 68% and 68% at 1, 2, 3, 4, 5 and 6 years respectively. Better results were found in patients with BMI 30-39. Resolution of comorbidities was seen in the majority of patients. In patients with a complete 2-year follow-up, failure (<25% EWL, lost to follow-up, band explanted) rate was 9.5%. Two years post-operatively, 77 patients (8%) underwent plastic surgery (mostly abdominoplasty). Sixty-eight pregnancies have been reported.
CONCLUSION: LAGB is a safe and reversible procedure, offering excellent long-term results for the treatment of severe obesity.
2. LONG-TERM RESULTS OF LAGB IN PATIENTS WITH LOW BMI (BMI 35-40 AND NO CO-MORBIDITY AND BMI<35)
BACKGROUND: LAGB is a worldwide popular bariatric procedure. Current selection criteria do not include patients with BMI<40 and no co-morbidities and surgery is not recommended in patients with BMI<35. In this retrospective analysis we studied the safety, effectiveness and long-term results of LAGB in these groups of patients.
METHODS: Patients were offered surgical treatment after thorough, multidisciplinary work-up. The study included 147 patients with BMI 35-40 and no co-morbidities (group A) and 107 patients with BMI<35(group B) Mean preoperative BMI and body weight were 37.5±1.1 kg/m2, 109±13 kg and 33.3±1.2, 94.7±4.7 respectively. Mean follow-up for group A was 37±14 months (range 12-68) and for group B 39.6±12.5 months (range 12-65)
RESULTS: The operation was completed laparoscopically in all patients with no peri-operative complications. Mean operative time and hospital stay were 46±6 min and 24 hrs respectively. Mean percentage of EWL at 1,2,3,4,5 years was 59%, 71%, 72%, 75%, 74% for group A and 68%, 73%, 72%, 78%, 79% for group B. In group A slippage was found in 3.4%, erosion in 0.7% and failure in 10%. In group B slippage was found in 4.6%, erosion in 3.5% and failure in 10%.
CONCLUSION: In patients with low BMI, LAGB is a safe, easy to perform, reversible procedure, offering excellent long-term results. With additional studies, demonstrating long-term effectiveness of LAGB, it is reasonable to expect the selection criteria for bariatric surgery to be altered.
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MEDIA
DIGITAL MEDIA STUDIO
