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Randomized clinical trial of laparoscopic gastric bypass versus laparoscopic duodenal switch for superobesity.

Artikel i vetenskaplig tidskrift
Författare T T Søvik
O Taha
E T Aasheim
My Engström
J Kristinsson
S Björkman
C F Schou
Hans Lönroth
T Mala
Torsten Olbers
Publicerad i The British journal of surgery
Volym 97
Nummer/häfte 2
Sidor 160-6
ISSN 1365-2168
Publiceringsår 2010
Publicerad vid Institutionen för kliniska vetenskaper, Avdelningen för gastrokirurgisk forskning och utbildning
Sidor 160-6
Språk en
Länkar dx.doi.org/10.1002/bjs.6802
Ämnesord Adult, Body Mass Index, Duodenum, surgery, Female, Gastric Bypass, methods, Humans, Laparoscopy, methods, Male, Obesity, Morbid, surgery, Preoperative Care, methods, Treatment Outcome
Ämneskategorier Medicin och Hälsovetenskap, Kirurgi

Sammanfattning

BACKGROUND:: Laparoscopic Roux-en-$\font\ss=cmss10 scaled 1000 \hbox{Y}$ gastric bypass (LRYGB) and laparoscopic biliopancreatic diversion with duodenal switch (LDS) are surgical options for superobesity. A randomized trial was conducted to evaluate perioperative (30-day) safety and 1-year results. METHODS:: Sixty patients with a body mass index (BMI) of 50-60 kg/m(2) were randomized to LRYGB or LDS. BMI, percentage of excess BMI lost, complications and readmissions were compared between groups. RESULTS:: Patient characteristics were similar in the two groups. Mean operating time was 91 min for LRYGB and 206 min for LDS (P < 0.001). One LDS was converted to open surgery. Early complications occurred in four patients undergoing LRYGB and seven having LDS (P = 0.327), with no deaths. Median stay was 2 days after LRYGB and 4 days after LDS (P < 0.001). Four and nine patients respectively had late complications (P = 0.121). Mean BMI at 1 year decreased from 54.8 to 38.5 kg/m(2) after LRYGB and from 55.2 to 32.5 kg/m(2) after LDS; percentage of excess BMI lost was greater after LDS (74.8 versus 54.4 per cent; P < 0.001). CONCLUSION:: LRYGB and LDS can be performed with comparable perioperative safety in superobese patients. LDS provides greater weight loss in the first year. Registration number: NCT00327912 (http://www.clinicaltrials.gov). Copyright (c) 2009 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.

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