Melissas John, Daskalakis Markos, Koukouraki Sophia, Askoxylakis Ioannis, Metaxari Maria, Dimitriadis Efstathios, Stathaki Maria, Papadakis John A
Bariatric Unit Department of Surgical Oncology, Heraklion University Hospital, Medical School, University of Crete, 15 Delaporta St., Herarklion 71409, Crete, Greece.
Obes Surg. 2008 Oct;18(10):1251-6. doi: 10.1007/s11695-008-9634-4. Epub 2008 Jul 29.
Sleeve gastrectomy (SG), which, thus far, is showing good resolution of comorbidities and good weight loss, shows increasing popularity among bariatric surgeons. The aim of this study was to evaluate clinical outcome and the gastric emptying of solid foods, 24 months after SG.
Fourteen morbidly obese patients, four males and ten females, median age 41 years (range 29-65), median body mass index (BMI) 49.46 kg/m(2) (range 41.14-55.63), who underwent SG for weight loss, were studied prospectively. Nine patients underwent gastric emptying studies, using radioisotopic technique before, 6 months and 24 months after the operation. The remaining five patients underwent gastric emptying studies, 6 months and 24 months after the operation.
A significant reduction in patients' weight and BMI was evident at 6, 12 and 24 months postoperatively. In the nine patients who underwent gastric emptying studies pre-, 6 and 24 months postoperatively, the T-lag phase duration significantly decreased, following the SG, from 17.30 (range 15.50-20.90) min, to 12.50 (range 9.20-18.00) min at 6 months and 12.16 (range 10.90-20.00) min at 24 months postoperatively (P < 0.05). The gastric emptying half time (T1/2) accelerated significantly postoperatively from 86.50 (range 77.50-104.60) min, to 62.50 (range 46.30-80.00) min at 6 months and 60.80 (range 54.80-100.00) min at 24 months after SG (P < 0.05). The percentage of gastric emptying (%GE) increased significantly postoperatively, from 52 (range 43-58) % to 72 (range 57-97) % at 6 months and 74 (range 45-82) % at 24 months, following SG (P < 0.05). No differences in gastric emptying were observed, when values at 24 months were compared to those at 6 months postoperatively. When the whole group of 14 patients was studied, there were also no significant changes in T-lag, T1/2 and %GE between 6 and 24 months postoperatively.
Our study indicates the constant effect of SG in the acceleration of gastric emptying of solids, which occurs faster, not only in short but also in long-term postoperatively. Such effects on gastric motility, in combination with the reported alterations in gut hormones, may explain how this 'food limiting' operation results in weight loss.
袖状胃切除术（SG）迄今为止在解决合并症方面效果良好且减重效果显著，在减重外科医生中越来越受欢迎。本研究的目的是评估SG术后24个月的临床结局以及固体食物的胃排空情况。
对14例接受SG以减重的病态肥胖患者进行前瞻性研究，其中4例男性，10例女性，中位年龄41岁（范围29 - 65岁），中位体重指数（BMI）49.46 kg/m²（范围41.14 - 55.63）。9例患者在术前、术后6个月和24个月采用放射性同位素技术进行胃排空研究。其余5例患者在术后6个月和24个月进行胃排空研究。
术后6个月、12个月和24个月时，患者体重和BMI显著降低。在术前、术后6个月和24个月进行胃排空研究的9例患者中，SG术后T延迟期持续时间显著缩短，从17.30（范围15.50 - 20.90）分钟降至术后6个月时的12.50（范围9.20 - 18.00）分钟以及术后24个月时的12.16（范围10.90 - 20.00）分钟（P < 0.05）。胃排空半衰期（T1/2）术后显著加快，从86.50（范围77.50 - 104.60）分钟降至术后6个月时的62.50（范围46.30 - 8,00）分钟以及SG术后24个月时的60.80（范围54.80 - 100.00）分钟（P < 0.05）。术后胃排空百分比（%GE）显著增加，从52（范围43 - 58）%增至术后6个月时的72（范围57 - 97）%以及术后24个月时的74（范围45 - 82）%（P < 0.05）。将术后24个月的值与术后6个月的值进行比较时，未观察到胃排空的差异。当对14例患者的整个队列进行研究时，术后6个月和24个月之间T延迟期、T1/2和%GE也没有显著变化。
我们的研究表明SG对加速固体食物的胃排空具有持续作用，这种加速不仅发生在术后短期内，也发生在长期。这种对胃动力的影响，结合报道的肠道激素变化，可能解释了这种“限制食物摄入”的手术如何导致体重减轻。
