Division of Laparoscopic Surgery, Department of Surgery, Mount Sinai Medical Center, New York, NY, USA.
Surg Endosc. 2010 Oct;24(10):2513-7. doi: 10.1007/s00464-010-0995-0. Epub 2010 Mar 26.
This study aimed to compare the rates for resolution and improvement of common comorbidities between laparoscopic sleeve gastrectomy (LSG) and laparoscopic adjustable gastric banding. The comorbid conditions included were type 2 diabetes mellitus (DM), hypertension (HTN), hyperlipidemias (LPD), degenerative joint disease (DJD), gastroesophageal reflux disease (GERD), obstructive sleep apnea (OSA), and asthma.
A retrospective chart review of the patients who underwent LSG or laparoscopic adjustable gastric banding at our institution from July 2004 to July 2007 was performed. The resolution of comorbidities was determined via patient-completed questionnaires and objective data.
Of the 123 patients (29 men and 94 women) reviewed, 49 had undergone LSG, and 74 had undergone laparoscopic adjustable gastric banding. The mean preoperative body mass index (BMI) was 52 kg/m(2) for the LSG patients and 44 kg/m(2) for the laparoscopic adjustable gastric banding patients. The overall percentages of excess weight loss (%EWL) were respectively 50.6 and 40.3% (P = 0.03) during mean follow-up periods of 15 and 17 months. There was a greater resolution or improvement of DM after LSG (100% vs 46%), HTN (78% vs 48%), and LPD (87% vs. 50%) than after laparoscopic adjustable gastric banding. Other comorbidities resolved or improved at a similar rate.
Although both LSG and laparoscopic adjustable gastric banding resulted in postoperative improvement or resolution of comorbidities associated with obesity, LSG statistically showed a significantly higher rate of resolution or improvement of DM, HTN, and LPD. There was no significant difference between the groups for DJD, GERD, OSA, or asthma.
本研究旨在比较腹腔镜袖状胃切除术（LSG）和腹腔镜可调胃束带术（LAGB）治疗常见合并症的缓解和改善率。合并症包括 2 型糖尿病（DM）、高血压（HTN）、高脂血症（LPD）、退行性关节病（DJD）、胃食管反流病（GERD）、阻塞性睡眠呼吸暂停（OSA）和哮喘。
对 2004 年 7 月至 2007 年 7 月在我院行 LSG 或 LAGB 的患者进行回顾性病历分析。通过患者完成的问卷调查和客观数据确定合并症的缓解情况。
在 123 例患者（29 名男性和 94 名女性）中，49 例接受 LSG，74 例接受 LAGB。LSG 患者的术前平均体重指数（BMI）为 52kg/m²，LAGB 患者为 44kg/m²。在平均 15 个月和 17 个月的随访期间，LSG 组的超重减轻百分比（%EWL）分别为 50.6%和 40.3%（P=0.03）。与 LAGB 相比，LSG 术后 DM（100% vs 46%）、HTN（78% vs 48%）和 LPD（87% vs. 50%）的缓解率更高。其他合并症的缓解率相似。
虽然 LSG 和 LAGB 均可改善与肥胖相关的合并症，但 LSG 统计学上显示 DM、HTN 和 LPD 的缓解率更高。两组在 DJD、GERD、OSA 或哮喘方面无显著差异。
