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腹腔镜 Roux-en-Y 胃旁路术与腹腔镜袖状胃切除术治疗病态肥胖。一项前瞻性研究 117 例患者。

Laparoscopic Roux-en-Y gastric bypass versus laparoscopic sleeve gastrectomy for the treatment of morbid obesity. A prospective study of 117 patients.

机构信息

Department of Surgery, Faculty of Medicine, Hospital Universitario de Caracas, Universidad Central de Venezuela, Caracas, Venezuela.

出版信息

Obes Surg. 2011 Feb;21(2):212-6. doi: 10.1007/s11695-010-0279-8.

Abstract

Laparoscopic Roux-en-Y gastric bypass (LRYGB) is one of the most widely used bariatric procedures today, and laparoscopic sleeve gastrectomy (LSG) as a single-stage procedure for the treatment of morbid obesity is becoming increasingly popular. In this study, we prospectively compared both techniques in order to establish whether there is any superiority of one over the other based on morbidity and effectiveness. From January 2008 to December 2008, 117 obese patients with indication for bariatric surgery were assigned by patient choice after informed consent to either a LRYGB procedure (n = 75) or a LSG procedure (n = 42). We determined operative time, length of stay, morbidity, co-morbidity outcomes, and excess weight loss at 1 year postoperative. Both groups were comparable in age, sex, body mass index, and co-morbidities. Mean operative time of LSG was 82 min while LRYGB was 98 min (p < 0.05). Differences in length of stay, major complications, improvement in co-morbidities, and excess weight loss were not significant (p > 0.05). One year after surgery, average excess weight loss was 86% in LRYGB and 78.8% in LSG (p > 0.05). In the short term, both techniques are comparable regarding safety and effectiveness, so not one procedure is clearly superior to the other.

摘要

腹腔镜 Roux-en-Y 胃旁路术(LRYGB)是当今最广泛使用的减肥手术之一,而腹腔镜袖状胃切除术(LSG)作为一种治疗病态肥胖的单一阶段手术,越来越受到欢迎。本研究前瞻性比较了这两种技术,以确定基于发病率和效果,是否有一种技术优于另一种技术。

从 2008 年 1 月至 2008 年 12 月,117 名肥胖患者经知情同意后,根据患者选择,被分配接受 LRYGB 手术(n=75)或 LSG 手术(n=42)。我们确定了手术时间、住院时间、发病率、合并症结果以及术后 1 年的超重减轻情况。两组在年龄、性别、体重指数和合并症方面具有可比性。LSG 的平均手术时间为 82 分钟,而 LRYGB 为 98 分钟(p<0.05)。住院时间、主要并发症、合并症改善和超重减轻的差异无统计学意义(p>0.05)。手术后 1 年,LRYGB 的平均超重减轻率为 86%,LSG 为 78.8%(p>0.05)。

在短期内,这两种技术在安全性和有效性方面相当,因此没有一种技术明显优于另一种技术。

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