Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China.
Obes Rev. 2011 Apr;12(4):254-60. doi: 10.1111/j.1467-789X.2010.00757.x.
The aim of this meta-analysis was to assess the effects of laparoscopic vs. open gastric bypass for morbid obesity. A systematic review of the literature was undertaken to assess randomized controlled trials on laparoscopic and open gastric bypass for morbid obesity. Six randomized controlled trials involving a total of 422 patients were included. There were 214 patients in the laparoscopic group and 208 patients in the open group separately. Compared with open surgery, laparoscopic surgery for morbid obesity could significantly shorten hospital stays (WMD=-1.11 d, 95% confidence interval [CI][-1.65, -0.56]). However, laparoscopic surgery for morbid obesity showed higher re-operation (RR=4.82, 95% CI [1.29, 17.98]) and longer surgical time (WMD=28.00 min, 95% CI [7.84, 48.16]). There were no statistical differences in complication (RR=0.84, 95% CI [0.64, 1.10]) and weight loss (WMD=1.00 kg m(-2), 95% CI [-0.79, 2.79]). The effects of laparoscopic and open gastric bypass for morbid obesity were basically the same except that laparoscopic had a shorter hospital stay and open surgery had a rate of fewer re-operations and shorter surgical time. Further high-quality, long follow-up period randomized controlled trials should be carried out to provide more reliable evidence.
本荟萃分析旨在评估腹腔镜与开腹胃旁路手术治疗病态肥胖的效果。我们系统地回顾了评估腹腔镜和开腹胃旁路手术治疗病态肥胖的随机对照试验的文献。共有 6 项随机对照试验，总计 422 名患者纳入研究。腹腔镜组有 214 名患者，开腹组有 208 名患者。与开腹手术相比，腹腔镜手术治疗病态肥胖可显著缩短住院时间（WMD=-1.11d，95%置信区间[-1.65，-0.56]）。然而，腹腔镜手术治疗病态肥胖的再手术率更高（RR=4.82，95%置信区间[1.29，17.98]），手术时间更长（WMD=28.00min，95%置信区间[7.84，48.16]）。两组并发症发生率（RR=0.84，95%置信区间[0.64，1.10]）和体重减轻（WMD=1.00kg·m(-2)，95%置信区间[-0.79，2.79]）无统计学差异。腹腔镜和开腹胃旁路手术治疗病态肥胖的效果基本相同，只是腹腔镜手术的住院时间较短，开腹手术的再手术率较低，手术时间较短。需要进一步开展高质量、长期随访的随机对照试验，以提供更可靠的证据。
