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Randomized clinical trial of laparoscopic Roux-en-Y gastric bypass versus laparoscopic vertical banded gastroplasty for obesity.

Artikel i vetenskaplig tidskrift
Författare Torsten Olbers
Monika Fagevik Olsén
Almantas Maleckas
Hans Lönroth
Publicerad i The British journal of surgery
Volym 92
Nummer/häfte 5
Sidor 557-62
ISSN 0007-1323
Publiceringsår 2005
Publicerad vid Institutionen för arbetsterapi och fysioterapi
Institutionen för de kirurgiska disciplinerna, Avdelningen för kirurgi
Sidor 557-62
Språk en
Länkar dx.doi.org/10.1002/bjs.4974
Ämnesord Adult, Anastomosis, Roux-en-Y, methods, Body Mass Index, Female, Forced Expiratory Volume, physiology, Gastric Bypass, Gastroplasty, methods, Hand Strength, Humans, Laparoscopy, methods, Length of Stay, Male, Middle Aged, Obesity, surgery, Oxygen, blood, Peak Expiratory Flow Rate, physiology, Statistics, Nonparametric
Ämneskategorier Medicin och Hälsovetenskap

Sammanfattning

BACKGROUND: Laparoscopic techniques have been developed for performing Roux-en-Y gastric bypass (LRYGBP) and vertical banded gastroplasty (LVBG) in patients with morbid obesity. It is not certain, however, which is the better technique in non-superobese patients (body mass index less than 50 kg/m(2)). METHODS: Eighty-three patients (LRYGBP 37, LVBG 46) were assessed in a randomized clinical trial. Perioperative complications were recorded together with preoperative and postoperative respiratory function and mobilization rate. Patients were monitored for 2 years after operation with regard to weight change and the need for remedial surgery. RESULTS: There were no conversions to open surgery. The mean operating time was longer for LRYGBP than LVBG (138 versus 105 min). Five early reoperations were performed after LRYGBP (three for haemorrhage, one for ileus and one suspected leak) and one after LVBG (suspected leak). There were no differences in postoperative respiratory function or mobilization. Weight reduction was greater after LRYGBP (excess weight loss 78.3 versus 62.9 per cent 1 year after surgery, P = 0.009; 84.4 versus 59.8 per cent at 2 years, P < 0.001). Remedial surgical intervention was required in eight patients after LVBG (conversion to Roux-en-Ygastric bypass) and none after LRYGBP. CONCLUSION: LRYGBP and LVBG were comparable in terms of operative safety and postoperative recovery, but weight reduction was better after LRYGBP.

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