Moon Han Sang, Kim Won Woo, Oh Ji Hyun
Department of Surgery, Kangnam CHA Hospital, School of Medicine, Pochon CHA University, Seoul, South Korea.
Obes Surg. 2005 Nov-Dec;15(10):1469-75. doi: 10.1381/096089205774859227.
In Asia, the type and main cause of obesity is different than in western society. Therefore, the treatment plan should be differentiated, and the surgery for morbid obesity should be carefully chosen. The early results of laparoscopic sleeve gastrectomy (LSG) without duodenal switch that has been performed in the Korean population is reported.
We retrospectively reviewed 130 patients who underwent LSG from January 2003 to May 2004. 60 of these patients now had >1 year of regular follow-up, and are the subject of this report. LSG was performed through 4 12-mm ports and 1 15-mm port, using the Endo-GIA stapler to create a lesser curve gastric tube over a 48-Fr bougie.
For the 60 patients, the postoperative EWL was 71.6+/-21.9% at 6 months and 83.3+/-28.3% at 12 months. At 12 months after LSG, decrease in BMI was 9.2+/-3.7 kg/m2, and median weight loss was 24.6+/-10.0 kg. Dyslipidemia resolved in 75% of patients within 12 months. Diabetes resolved in 100% of patients within 6 months of operation. Hypertension resolved in 92.9% and improved in 100%. Joint pain resolved in 100% within 12 months. Weight loss plateaued at 12 months in the majority of patients. One patient has undergone a malabsorption procedure (duodenal switch) as a second-stage operation.
Additional studies and follow-up are needed to determine the best surgical treatment for morbidly obese Asian patients. However, LSG without the second-stage duodenal switch operation has been an effective weight loss operation thus far, in most of the Korean patients.
在亚洲，肥胖的类型和主要成因与西方社会不同。因此，治疗方案应有所区别，对于病态肥胖的手术治疗应谨慎选择。本文报道了在韩国人群中开展的不进行十二指肠转位的腹腔镜袖状胃切除术（LSG）的早期结果。
我们回顾性分析了2003年1月至2004年5月间接受LSG手术的130例患者。其中60例患者目前已进行了超过1年的定期随访，是本报告的研究对象。LSG通过4个12毫米端口和1个15毫米端口进行，使用Endo - GIA吻合器在48F探条引导下制作较小弯胃管。
对于这60例患者，术后6个月的额外体重减少（EWL）为71.6±21.9%，12个月时为83.3±28.3%。LSG术后12个月，体重指数（BMI）下降9.2±3.7kg/m²，平均体重减轻24.6±10.0kg。75%的患者在12个月内血脂异常得到缓解。100%的患者在术后6个月内糖尿病得到缓解。92.9%的高血压患者症状得到缓解，100%的患者病情有所改善。100%的患者在12个月内关节疼痛症状消失。大多数患者在12个月时体重减轻趋于平稳。1例患者接受了作为二期手术的吸收不良手术（十二指肠转位）。
需要进一步的研究和随访来确定针对病态肥胖亚洲患者的最佳手术治疗方案。然而，迄今为止，对于大多数韩国患者而言，不进行二期十二指肠转位手术的LSG是一种有效的减肥手术。
