Arias Enrique, Martínez Pedro R, Ka Ming Li Vicky, Szomstein Samuel, Rosenthal Raul J
The Bariatric and Metabolic Institute, Section of Minimally Invasive and Endoscopic Surgery, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd, Weston, FL, 33331, USA.
Obes Surg. 2009 May;19(5):544-8. doi: 10.1007/s11695-009-9818-6. Epub 2009 Mar 12.
In previous publications, we demonstrated the safety and short-term efficacy of laparoscopic sleeve gastrectomy (LSG) as a final step in the treatment of morbid obesity (MO). This study aimed to assess the mid-term efficacy of LSG.
We performed a retrospective review of a prospectively collected database. Between November 2004 and January 2007, 130 consecutive patients underwent LSG as a final procedure to MO. Data including patient demographics, operative time, length of hospital stay, complications, preoperative body mass index (BMI), complications, and weight loss at 3, 6, 12, 18, and 24 months were recorded and analyzed.
The mean age was 45.6 (range: 12-79) years while the mean BMI was 43.2 (range: 30.2-75.4) kg/m(2). The mean operative time was 97 (range, 58-180) min and all operations were completed laparoscopically. The mean hospital stay was 3.2 (range, 1-19) days with zero mortality in this series. One patient (0.7%) had leakage at the stapler line, while four patients (2.8%) developed trocar site infection. Three patients (2.1%) complained of symptoms of gastroesophageal reflux disease (GERD), three patients (2.1 %) developed symptomatic gallstones, and trocar site hernia was present in one (0.7%) patient. The mean weight loss was 21, 31.2, 37.4, 39.5, and 41.7 kg at 3, 6, 12, 18, and 24 months, respectively, while the mean BMI decreased to 36.9, 32.8, 29.5, 28, and 27.1 at 3, 6, 12 18, and 24 months, respectively. Percent of excess weight loss (%EWL) was 33.1, 50.8, 62.2, 64.4, and 67.9 at 3, 6, 12, 18, and 24 months, respectively.
LSG is a safe and effective surgical procedure for the morbidly obese up to 2 years. Excess body weight loss seems to be acceptable at 2 years postoperatively.
在之前的出版物中，我们证明了腹腔镜袖状胃切除术（LSG）作为治疗病态肥胖（MO）的最后一步的安全性和短期疗效。本研究旨在评估LSG的中期疗效。
我们对前瞻性收集的数据库进行了回顾性分析。在2004年11月至2007年1月期间，130例连续患者接受了LSG作为MO的最终手术。记录并分析了包括患者人口统计学、手术时间、住院时间、并发症、术前体重指数（BMI）、并发症以及3、6、12、18和24个月时的体重减轻等数据。
平均年龄为45.6岁（范围：12 - 79岁），平均BMI为43.2 kg/m²（范围：30.2 - 75.4 kg/m²）。平均手术时间为97分钟（范围：58 - 180分钟），所有手术均通过腹腔镜完成。本系列患者的平均住院时间为3.2天（范围：1 - 19天），无死亡病例。1例患者（0.7%）在吻合器线处发生渗漏，4例患者（2.8%）发生穿刺部位感染。3例患者（2.1%）出现胃食管反流病（GERD）症状，3例患者（2.1%）出现有症状的胆结石，1例患者（0.7%）出现穿刺部位疝。在3、6、12、18和24个月时，平均体重减轻分别为21、31.2、37.4、39.5和41.7 kg，而平均BMI在3、6、12、18和24个月时分别降至36.9、32.8、29.5、28和27.1。在3、6、12、18和24个月时，超重减轻百分比（%EWL）分别为33.1%、50.8%、62.2%、64.4%和67.9%。
LSG对于病态肥胖患者在长达2年的时间内是一种安全有效的手术方法。术后2年时多余体重减轻似乎是可以接受的。
