BACKGROUND:Early and late dumping are complications of gastric bypass surgery. Early dumping occurs within an hour after eating, when the emptying of food into the small intestine triggers rapid fluid shifts into the intestinal lumen and the release of gastrointestinal hormones, resulting in gastrointestinal and vasomotor symptoms. Late dumping occurs between 1 and 3 hours after carbohydrate ingestion and is caused by an exaggerated insulin release, resulting in hypoglycemia. Almost no data are currently available on the prevalence of early and late dumping or their impact on health-related quality of life (QoL). OBJECTIVES:To study the prevalence of early and late dumping in a large population of patients having undergone a primary Roux-en-Y gastric bypass (RYGB) and its effect on QoL. SETTING:Cross-sectional study at a single bariatric department in the Medical Center Leeuwarden, The Netherlands between 2008 and 2011. METHODS:In 2013, this descriptive cohort study approached by email or post all patients who underwent a primary RYGB in the setting between 2008 and 2011 in one hospital. These patients were asked to fill in standardized questionnaires measuring their QoL (RAND-36), anxiety and depression (HADS), fatigue (MFI-20) and any disease specific indicators of early and late dumping syndrome. RESULTS:The questionnaire was completed and returned by 351 of 613 patients (57.1%) and 121 nonobese volunteers. Participants were mostly female (80%), aged 42 (40-54 years), with an excess weight loss of 76.8% [IQR 61-95] after RYGB surgery 2.3 [ IQR 1.6-3.4] years earlier. Self-reported complaints of moderate to severe intensity suggestive of early and late dumping were present in 18.8% and 11.7% of patients, respectively. Patients with early and late dumping demonstrated significantly lower scores on the RAND-36 and HADS compared with patients without dumping. No differences were seen in the MFI-20 scores between patients with or without early and late dumping. CONCLUSION:In this descriptive cohort, self-reported complaints suggestive of early and late dumping of moderate-to-severe intensity were, respectively, 18.8% and 11.7% in a cohort after primary gastric bypass surgery. These complaints were associated with markedly reduced health-related QoL.

译文

背景:早期和晚期倾倒是胃搭桥手术的并发症。进食后一小时内会发生早期倾倒,这是因为食物排入小肠会触发液体快速进入肠腔并释放胃肠激素,从而导致胃肠道和血管舒缩症状。延迟进食发生在摄入碳水化合物后的1至3个小时之间,并且是由于胰岛素释放过大引起的,从而导致低血糖症。当前几乎没有关于早期和晚期倾倒的流行率或其对健康相关生活质量(QoL)的影响的数据。
目的:研究大量初次Roux-en-Y胃搭桥术(RYGB)患者的早期和晚期倾倒的发生率及其对QoL的影响。
地点:2008年至2011年,在荷兰吕伐登医学中心的单个减肥科进行横断面研究。
方法:2013年,该描述性队列研究通过电子邮件或将所有在2008年至2011年之间在某医院接受原发性RYGB治疗的患者纳入研究。这些患者被要求填写标准化问卷,以测量他们的生活质量(RAND-36),焦虑和抑郁(HADS),疲劳(MFI-20)以及早期和晚期倾倒综合征的任何疾病特异性指标。
结果:613例患者中的351例(占57.1%)和121例非肥胖志愿者完成了问卷调查并返回。参与者主要是女性(80%),42岁(40-54岁),在RYGB手术2.3年[IQR 1.6-3.4]之前,体重减轻了76.8%[IQR 61-95]。自我报告的中度至重度暗示早期和晚期倾倒的投诉分别占患者的18.8%和11.7%。与没有倾倒的患者相比,早期和晚期倾倒的患者在RAND-36和HADS上的得分明显较低。在有或没有早期和晚期倾倒的患者之间,MFI-20评分均未见差异。
结论:在这个描述性队列中,自我报告的关于初次胃旁路手术后队列中早期至晚期倾倒中度至重度的抱怨分别为18.8%和11.7%。这些投诉与健康相关的生活质量显着降低有关。

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