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Árangur magahjáveituaðgerða á Íslandi 2001-2015

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Authors
Þórarinsdóttir, Rósamunda
Pálmason, Vilhjálmur
Leifsson, Björn Geir
Gíslason, Hjörtur
Útgáfudagur
2016-10-06

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Önnur málmynd
Outcome of gastric bypass surgery in Iceland 2001-2015
Citation
Árangur magahjáveituaðgerða á Íslandi 2001-2015 2016, 2016 (10):426 Læknablaðið
Útdráttur
Inngangur: Magahjáveituaðgerðir með kviðsjártækni hafa verið framkvæmdar á Landspítala frá árinu 2001. Aðgerðirnar eru mikilvægur með- ferðarmöguleiki fyrir sjúklinga með sjúklega offitu. Markmið þessarar rannsóknar var að kanna langtímaárangur slíkra aðgerða hérlendis. Efniviður og aðferðir: Rannsóknin tók til 772 sjúklinga sem gengust undir magahjáveituaðgerð á Landspítala árin 2001-2015. Upplýsinga var aflað úr framskyggnum gagnagrunni offituaðgerða sem er hluti af sjúkraskrárkerfi spítala. Fullnægjandi þyngdartap var skilgreint sem annaðhvort þyngdarstuðull undir 33 kg/m2 eða meira en helmingstap af yfirþyngd (%EBMIL skilgreint sem prósenta af tapi á yfirþyngd, umfram þyngdarstuðul 25 kg/m2 ). Niðurstöður: Meðalaldur sjúklinga var 41 ár. 83% voru konur. Meðal- þyngd sjúklinga var 127 kg (±20) og líkamsþyngdarstuðull (BMI, kg/m2 ) var 44 (±6) að meðaltali. Meðal %EBMIL var 80% eða 57 kg (±15) eftir 1,5 ár, 70% eða 50 kg (±15) eftir 5 ár og 64% eða 48 kg (±14) eftir 10-13 ár. 85% sjúklinga náðu fullnægjandi þyngdartapi með meðaleftirfylgni 7,4 ár eftir aðgerð. Sjúklingar voru að meðaltali með 2,8 fylgisjúkdóma offitu fyrir aðgerð. 71% sjúklinga með sykursýki af tegund tvö fyrir aðgerð fóru í fullt sjúkdómshlé eftir aðgerð. Rúmlega þriðjungur sjúklinga með háþrýsting eða blóðfituraskanir urðu lyfjalausir eftir aðgerð. Snemmkomna fylgikvilla fengu 37 (5%) sjúklingar og fór helmingur þeirra í bráðaaðgerð. Síðkomna fylgikvilla eftir aðgerð fékk fjórðungur sjúklinga (174). Hjá flestum sjúklinganna (78%) þurfti að gera endurteknar breytingar á inntöku vítamína og bætiefna í samræmi við niðurstöður blóðprufa í eftirliti. Ályktun: Magahjáveituaðgerð hjálpar meirihluta sjúklinga að ná tilsettu þyngdartapi. Samhliða því fékk meirihluti sjúklinga bót á fylgisjúkdómum offitu. Snemmkomnir fylgikvillar voru fátíðir en um fjórðungur sjúklinga fékk síðkomna fylgikvilla sem stundum kröfðust nýrrar aðgerðar. Sjúklingar sem fara í magahjáveituaðgerð þurfa á ævilöngu eftirliti á næringar- ástandi að halda.
Introduction: Laparoscopic roux-en-y gastric bypass (LRYGB) has been performed at Landspitali University Hospital (LSH) since 2001. The procedure represents an important treatment option for morbidly obese patients. The aim of this study is to evaluate the long-term results of these operations in Iceland. Material and methods: All 772 consecutive patients undergoing LRYGB at LSH during 2001-2015 were included. Information was collected from a prospective database. Successful weight loss was defined as body mass index (BMI) less than 33 kg/m2 or excess body mass index loss (EBMIL) more than 50%. Results: Mean age of patients was 41 years and 83% were females. Mean pre-operative weight was 127 kg (±20) and mean BMI was 44 (±6). Mean %EBMIL was 80% after 1.5 year, 70% after 5 years and 64% after 10-13 years. 85% of patients had successful weight loss with a mean follow-up time of 7.4 years. Pre-operatively patients on average had 2.8 obesity related comorbid diseases. 71% of patients with type 2 diabetes were in full remission after surgery. One third of patients with hypertension and one third of patients with hyperlipidemia achieved full remission after surgery. 37 patients (5%) had an early complication and 174 (25%) had a late complication that frequently needed surgical solution. Most patients (78%) needed repeated adjustment of vitamins and minerals often many years after surgery. Conclusion: Majority of patients achieved a successful weight loss and most obesity related comorbidities are still in remission 7.4 years after surgery. Early complications were rare but one fourth of patients had late complications. Life long follow-up is of utmost importance after gastric bypass surgery.
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http://www.laeknabladid.is/tolublod/2016/10/nr/6034
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Archived with thanks to Læknablaðið
ae974a485f413a2113503eed53cd6c53
10.17992/lbl.2016.10.100
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Icelandic Journal Articles (Peer Reviewed)

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