University of Vermont College of Medicine, Fletcher Allen Health Care, General/Minimally Invasive & Bariatric Surgery, 111 Colchester Ave., Smith 304, Burlington, VT 05401, USA.
Expert Rev Gastroenterol Hepatol. 2010 Feb;4(1):101-19. doi: 10.1586/egh.09.68.
While obesity and morbid obesity have reached epidemic proportions worldwide, bariatric surgeons continue to develop safer and more efficacious procedures to battle this lethal disease. Sleeve gastrectomy, a relative new surgical approach, was initially conceived as a restrictive component of the biliopancreatic diversion and duodenal switch in the era of open bariatric surgery. With the advent of minimally invasive surgery in the late 1980s, laparoscopic sleeve gastrectomy (LSG) has been proposed as a step procedure in high-risk patients, followed by a second step Roux-en-Y gastric bypass or biliopancreatic diversion and duodenal switch and, recently, as a standalone bariatric approach. This article reviews the literature and reports the results achieved with LSG performed either as the initial operation for high-risk, high body mass index patients followed by a definitive weight loss operation, or used as a final viable alternative to other well-established bariatric procedures. An extensive literature review was conducted and the information currently available surrounding LSG, such as history, indications and contraindications, mechanism of weight loss, technique and outcomes and controversial issues are discussed. LSG is an accepted procedure for the surgical management of morbid obesity. It is gaining popularity as a primary, staged and revisional operation for its proven safety and simplicity, as well as short-term and mid-term efficacy. Excess weight loss and remission of comorbidities have been reported to take place in a frequency comparable with other well-established procedures. Despite all of the above-mentioned factors, long-term results and larger series are pending.
尽管肥胖症和病态肥胖症已在全球范围内达到流行程度，但减重外科医生仍在继续开发更安全、更有效的手术方法来对抗这种致命疾病。袖状胃切除术是一种相对较新的手术方法，最初被设想为开放式减重手术时代的胆胰分流和十二指肠转位的限制部分。随着 20 世纪 80 年代后期微创技术的出现，腹腔镜袖状胃切除术（LSG）已被提议作为高危患者的分步手术，随后进行第二步 Roux-en-Y 胃旁路或胆胰分流和十二指肠转位，最近作为一种独立的减重方法。本文回顾了文献，并报告了在高危、高体重指数患者中作为初始手术进行 LSG 后进行确定性减重手术，或作为其他成熟减重手术的最终可行替代方案的结果。进行了广泛的文献回顾，并讨论了与 LSG 相关的信息，如历史、适应证和禁忌证、减重机制、技术和结果以及有争议的问题。LSG 是治疗病态肥胖症的一种可接受的手术方法。它作为一种原发性、分期和修正手术越来越受欢迎，因为其具有已证实的安全性和简单性，以及短期和中期疗效。据报道，超重减轻和合并症缓解的发生频率与其他成熟的手术方法相当。尽管存在所有上述因素，但仍有待长期结果和更大系列的研究。
