Department of Digestive Surgery, Amiens North Hospital, University of Picardy Medical Centre, Place Victor Pauchet, 80054, Amiens, France.
Obes Surg. 2010 Jun;20(6):679-84. doi: 10.1007/s11695-009-0007-4. Epub 2009 Nov 10.
Sleeve gastrectomy (SG) is an alternative to gastric bypass and laparoscopic adjustable gastric banding (GB).
From January 2004 to January 2006, 111 patients with a follow-up longer than 24 months were prospectively followed. Three treatment groups were defined. Sleeve gastrectomy as first procedure (SGFP; n = 50), sleeve gastrectomy after failure of GB (SG after GB; n = 9) and GB (n = 52). We compared morbidity, mortality, length of stay, number of procedures under general anaesthesia, excess weight loss (EWL) and quality of life.
Mean initial body mass index (BMI) was 50.4 (SG), 50.8 (SG after GB) and 43.8 (GB; p = 0.000001). Mean operating time was 97.1 min (SGFP), 122.2 min (SG after GB) and 69.8 min (GB; p < 0.0001). The reoperation rate under general anaesthesia was 2% (SGFP), 11% (SG after GB) and 30.76% (GB; p = 0.00001).The fistula rate was 2% (SGFP), 0% (SG after GB) and 0% (GB). BMI at 24 months was 33.8 (SGFP), 35.3 (SG after GB) and 33.2 (GB; NS). EWL at 24 months was 67.4 (SGFP), 60.3 (SG after GB) and 58.6 (GB; NS). In the SGFP group and in the SG after GB group, the mean quality-of-life score was 1.1. In the GB group, the mean score was 0.95 (NS).
Initial BMI was significantly higher in the SG group but was no longer significantly different from the BMI of the GB group at 12 and 24 months. Excess BMI loss was higher after SG than after GB. This reduction of BMI was considered to be a success for GB. Thus, results of SG should be considered as a success. Quality of life was not significantly different between the three groups. These results validated SG as first procedure or after failure of GB.
袖状胃切除术（SG）是胃旁路术和腹腔镜可调胃束带术（GB）的替代方法。
从 2004 年 1 月至 2006 年 1 月，对随访时间超过 24 个月的 111 例患者进行前瞻性随访。定义了三个治疗组。首次行袖状胃切除术（SGFP；n=50）、GB 失败后行袖状胃切除术（SG 后 GB；n=9）和 GB（n=52）。我们比较了发病率、死亡率、住院时间、全身麻醉下手术次数、多余体重减轻（EWL）和生活质量。
初始体重指数（BMI）平均值分别为 50.4（SG）、50.8（SG 后 GB）和 43.8（GB；p=0.000001）。手术时间平均值分别为 97.1 分钟（SGFP）、122.2 分钟（SG 后 GB）和 69.8 分钟（GB；p<0.0001）。全身麻醉下再次手术率分别为 2%（SGFP）、11%（SG 后 GB）和 30.76%（GB；p=0.00001）。瘘管发生率分别为 2%（SGFP）、0%（SG 后 GB）和 0%（GB）。24 个月时 BMI 分别为 33.8（SGFP）、35.3（SG 后 GB）和 33.2（GB；NS）。24 个月时 EWL 分别为 67.4（SGFP）、60.3（SG 后 GB）和 58.6（GB；NS）。在 SGFP 组和 SG 后 GB 组，平均生活质量评分均为 1.1。在 GB 组，平均评分为 0.95（NS）。
SG 组的初始 BMI 明显较高，但在 12 个月和 24 个月时，与 GB 组的 BMI 不再有显著差异。SG 后多余 BMI 减轻量高于 GB。这种 BMI 的降低被认为是 GB 的成功。因此，SG 的结果应被视为成功。三组之间的生活质量无显著差异。这些结果验证了 SG 作为首选方法或 GB 失败后的选择。
