腹腔镜袖状胃切除术:探条尺寸是否会影响平均%EWL?短期结果。
Laparoscopic sleeve gastrectomy: does bougie size affect mean %EWL? Short-term outcomes.
作者信息
Parikh Manish, Gagner Michel, Heacock Laura, Strain Gladys, Dakin Gregory, Pomp Alfons
机构信息
Section of Laparoscopic and Bariatric Surgery, Department of Surgery, Cornell University Weill College of Medicine, New York Presbyterian Hospital, New York, NY, USA.
出版信息
Surg Obes Relat Dis. 2008 Jul-Aug;4(4):528-33. doi: 10.1016/j.soard.2008.03.245.
BACKGROUND
Laparoscopic sleeve gastrectomy (LSG) has been increasingly offered to high-risk bariatric patients as the first-stage procedure before gastric bypass or biliopancreatic diversion or as the primary weight loss procedure. The bougie size has varied by surgeon during LSG. The aim of this study was to determine whether short-term weight loss correlates with the bougie size used during creation of the sleeve.
METHODS
We retrospectively reviewed the data from all patients who had undergone LSG at our institution between 2003 and 2006. Revision LSG for failed bariatric procedures was excluded. The data analyzed included preoperative age, body mass index (BMI), bougie size, and percentage of excess weight loss (%EWL).
RESULTS
A total of 135 patients underwent LSG during the 4-year period. Most of these patients (79%) underwent LSG as part of a 2-stage operation (either gastric bypass or duodenal switch within a mean of 11 months). The mean preoperative age and BMI was 43.5 years and 60.1 kg/m(2), respectively. The mean BMI and %EWL at 6 months was 47.1 kg/m(2) and 37.9%, respectively. The mean BMI and %EWL at 12 months was 44.3 kg/m(2) and 47.3%, respectively. When stratifying the %EWL by bougie size (40F versus 60F), we did not find a significant difference at 6 months (38.8% versus 40.6%, P = NS) or 12 months (51.9% versus 45.4%, P = NS).
CONCLUSION
LSG results in significant weight loss in the short term. When stratifying outcomes by bougie size, our results suggested that a bougie size of 40F compared with 60F does not result in significantly greater weight loss in the short term. However, longer follow-up of the primary LSG group is required to determine whether a difference becomes evident over time.
背景
腹腔镜袖状胃切除术(LSG)越来越多地被用于肥胖症高风险患者,作为胃旁路手术或胆胰分流术之前的第一阶段手术,或作为主要的减肥手术。在LSG手术过程中,探条的尺寸因外科医生而异。本研究的目的是确定短期体重减轻是否与创建袖状胃时使用的探条尺寸相关。
方法
我们回顾性分析了2003年至2006年期间在我院接受LSG手术的所有患者的数据。排除因减肥手术失败而进行的LSG翻修手术。分析的数据包括术前年龄、体重指数(BMI)、探条尺寸和超重减轻百分比(%EWL)。
结果
在4年期间,共有135例患者接受了LSG手术。这些患者中的大多数(79%)接受LSG手术作为两阶段手术的一部分(平均11个月内进行胃旁路手术或十二指肠转位手术)。术前平均年龄和BMI分别为43.5岁和60.1kg/m²。6个月时的平均BMI和%EWL分别为47.1kg/m²和37.9%。12个月时的平均BMI和%EWL分别为44.3kg/m²和47.3%。当按探条尺寸(40F对60F)对%EWL进行分层时,我们发现在6个月(38.8%对40.6%,P=无显著性差异)或12个月(51.9%对45.4%,P=无显著性差异)时没有显著差异。
结论
LSG在短期内可显著减轻体重。当按探条尺寸对结果进行分层时,我们的结果表明,40F的探条尺寸与60F相比,短期内不会导致显著更多的体重减轻。然而,需要对原发性LSG组进行更长时间的随访,以确定随着时间的推移差异是否会变得明显。