Arroyo Kervin, Alkhoury Faud, Nadzam Geoffrey, Valin Elmer
Department of Surgery, Hospital of Saint Raphael, New Haven, USA.
Conn Med. 2010 Nov-Dec;74(10):589-93.
Laparoscopic nonbanded restrictive procedures are becoming more popular as staging and primary operations in bariatric surgery. The Magenstrasse and Mill (MM) procedure produces a restrictive gastric tubular pouch based along the lesser curvature; for the most part anatomy and physiology are preserved. In Sleeve Gastrectomy (SG), 80% of normal stomach is resected to produce restriction and to decrease ghrelin levels.
This is a retrospective nonrandomized study evaluating the medical records of patients who had the laparoscopic MM (LMM) and laparoscopic SG (LSG) between January 2007 and October 2008. One bariatric surgeon performed the LMM and two bariatric surgeons performed the LSG.
A total of 20 patients were identified: 13 SG and 7 MM. The mean age was 50 for the MM vs 42.9 for the SG. For the MM, the mean preoperative body mass index (BMI) was 65.4 +/- 11.1 kg/m2, with a mean excess weight of 282 +/- 73.7 kg. For the SG, the mean preoperative body mass index was 47.5 +/- 8.3 kg/m2, with a mean excess weight of 156.1 +/- 52.6 kg. The mean excess weight loss after six and 12 months for the M&M was 35 +/- 10.5% and 20.1 +/- 1.4%, vs 52.4 +/- 17.8% and 49% +/- 15.4% for the SG. Follow-up of one year was achieved in two M&M patients and three SG patients. Median follow-up of all patients was seven months (range 12-1).
This is a short-term retrospective outcome study. The LMM patients were larger than LSG patients. Total weight loss was greater for the LMM patients. Operative time for the LMM is shorter. The percent excess weight loss in the short-term 12 month period was more in the LSG compared to the LMM. Long-term follow-up is needed.
腹腔镜非带环限制性手术作为减重手术中的分期手术和初次手术越来越受欢迎。马根施特拉瑟和米尔（MM）手术沿着胃小弯制作一个限制性胃管状囊袋；在很大程度上保留了解剖结构和生理功能。在袖状胃切除术（SG）中，切除80%的正常胃以产生限制作用并降低胃饥饿素水平。
这是一项回顾性非随机研究，评估2007年1月至2008年10月期间接受腹腔镜MM（LMM）和腹腔镜SG（LSG）手术患者的病历。一位减重外科医生实施LMM手术；两位减重外科医生实施LSG手术。
共确定了20例患者：13例SG患者和7例MM患者。MM组的平均年龄为50岁，而SG组为42.9岁。对于MM组，术前平均体重指数（BMI）为65.4±11.1kg/m²，平均超重282±73.7kg。对于SG组，术前平均体重指数为47.5±8.3kg/m²，平均超重156.1±52.6kg。MM组在6个月和12个月后的平均超重减轻率分别为35±10.5%和20.1±1.4%，而SG组分别为52.4±17.8%和49%±15.4%。2例MM患者和3例SG患者实现了1年的随访。所有患者的中位随访时间为7个月（范围12 - 1个月）。
这是一项短期回顾性结局研究。LMM组患者比LSG组患者体型更大。LMM组患者的总体体重减轻更多。LMM手术的手术时间更短。在12个月的短期时间内，SG组的超重减轻百分比高于LMM组。需要进行长期随访。
