Center for Minimal-Invasive Surgery, Department of General and Bariatric Surgery, Krankenhaus Sachsenhausen, Frankfurt/M., Germany.
Obes Facts. 2009;2 Suppl 1(Suppl 1):8-10. doi: 10.1159/000198239. Epub 2009 Mar 18.
Sleeve gastrectomy (SG) was initially described as a first-step procedure followed by either biliopancreatic diversion with duodenal switch or Roux-en-Y gastric bypass in super-super obese patients. Multiple recent reports have documented SG as single therapy in the treatment of morbid obesity. However,the indications for this procedure are still under evaluation.Accumulating data demonstrate that SG can be an effective and safe procedure for super-super-obese or high-risk patients either as a single operation or as a bridge to more definitive surgery. SG can also be performed in patients who require anti-inflammatory medication or in patients with conditions such as Crohn's disease, cirrhosis, anemia, or severe osteoporosis which preclude intestinal bypass. Furthermore,SG represents not only a safe alternative for morbidly obese patients on anticoagulant medication or immunosuppressive agents but also for those with multiple intra-abdominal adhesions or after failed gastric banding. In addition, SG can be performed safely in morbid obese adolescents. The main limitation of this novel bariatric procedure is the lack of longterm data on sustained weight loss and resolution of obesity related comorbidities. Moreover, the fact that SG is an irreversible operation adds to its weakness as a bariatric procedure, at least until definitive results concerning its efficacy are obtained. SG is effective and safe as a single-stage procedure for certain cohorts of patients. However, the broad application of SG as a single-stage procedure in the bariatric field can be established only if the procedure is standardized and longterm results are available.
袖状胃切除术（SG）最初被描述为一种第一步手术，随后在超级肥胖患者中进行胆胰分流术加十二指肠转位或 Roux-en-Y 胃旁路术。最近的多项报告已经证明 SG 可作为治疗病态肥胖的单一疗法。然而，该手术的适应证仍在评估中。越来越多的数据表明，SG 可以作为一种有效且安全的手术，无论是作为单一手术还是作为更确定性手术的桥梁，适用于超级肥胖或高危患者。SG 也可用于需要抗炎药物的患者，或患有克罗恩病、肝硬化、贫血或严重骨质疏松症等疾病的患者，这些疾病排除了肠旁路。此外，SG 不仅是抗凝药物或免疫抑制剂治疗的病态肥胖患者的安全替代方案，也是那些有多个腹腔粘连或胃束带失败的患者的安全替代方案。此外，SG 可安全用于病态肥胖的青少年。这种新型减肥手术的主要局限性是缺乏关于持续减重和肥胖相关合并症缓解的长期数据。此外，SG 是一种不可逆的手术，这增加了它作为减肥手术的弱点，至少在获得关于其疗效的明确结果之前是这样。SG 作为一种单一阶段的手术，对某些患者群体是有效和安全的。然而，只有当该手术标准化并且能够提供长期结果时，SG 才能作为一种单一阶段的手术在减肥领域广泛应用。
