腹腔镜袖状胃切除术的长期随访：8-9 年结果。

Long-term follow-up after laparoscopic sleeve gastrectomy: 8-9-year results.

机构信息

Department of Upper Gastrointestinal and Bariatric Surgery, St. James's University Hospital, Leeds, United Kingdom.

出版信息

Surg Obes Relat Dis. 2012 Nov-Dec;8(6):679-84. doi: 10.1016/j.soard.2011.06.020. Epub 2011 Jul 20.

DOI:10.1016/j.soard.2011.06.020

PMID:21890430

Abstract

BACKGROUND

Laparoscopic sleeve gastrectomy (LSG) has rapidly gained popularity as a definitive bariatric procedure despite the sparse long-term follow-up data. On the basis of extensive experience with the open Magenstrasse and Mill operation, we began practice of LSG in 2000. The objective of the present study was to analyze 8-9 years of our follow-up data for LSG at a university hospital in the United Kingdom.

METHODS

From January 2000 to December 2001, 20 patients underwent LSG. A 32F bougie was used for calibration in all cases.

RESULTS

The preoperative median body mass index was 45.8 kg/m(2) (range 35.8-63.7), and 9 patients (45%) were superobese (body mass index ≥ 50 kg/m(2)). For LSG as a definitive bariatric procedure, 8-9-year follow-up data were available for 13 patients. Of the remainder, 4 patients underwent revision surgery and 3 were lost to follow-up after 2 years. For the entire cohort, the median excess weight loss (EWL) was 73% (range 13-105%) at 1 year, 78% (range 22-98%) at 2 years, 73% (range 28-90%) at 3 years, and 68% (range 18-85%) at 8 or 9 years (P = .074). Of the 13 LSG-only patients with 8-9 years of follow-up, 11 (55% of the starting cohort) had >50% EWL at 8 or 9 years. No significant difference was found in the initial body mass index between the LSG-only patients with >50% EWL and others (45.9 kg/m(2), range 35.8-59.4 versus 45.7 kg/m(2), range 38.9-63.7, respectively; P = .70). The LSG-only patients with >50% EWL had a marginally significantly greater EWL at 1 year compared with the others (76%, range 48-103% versus 45%, range 13-99%, respectively; P = .058).

CONCLUSION

At 8-9 years of follow-up, 55% of patients had >50% EWL from LSG as a definitive bariatric procedure.

摘要

背景

腹腔镜袖状胃切除术（LSG）作为一种确定性减重手术，尽管长期随访数据有限，但已迅速普及。在我们广泛开展开放式 Magenstrasse 和 Mill 手术的基础上，我们于 2000 年开始开展 LSG 手术。本研究的目的是分析英国一家大学医院 8-9 年的 LSG 随访数据。

方法

2000 年 1 月至 2001 年 12 月，20 例患者接受了 LSG 手术。所有病例均使用 32F 探条进行校准。

结果

术前中位体重指数为 45.8kg/m2（范围 35.8-63.7），9 例（45%）为超肥胖（体重指数≥50kg/m2）。对于 LSG 作为一种确定性减重手术，13 例患者获得了 8-9 年的随访数据。其余患者中，4 例接受了修正手术，3 例在随访 2 年后失访。对于整个队列，1 年时中位超重体重减轻率（EWL）为 73%（范围 13-105%），2 年时为 78%（范围 22-98%），3 年时为 73%（范围 28-90%），8 或 9 年时为 68%（范围 18-85%）（P =.074）。在 13 例仅接受 LSG 治疗且随访 8-9 年的患者中，11 例（起始队列的 55%）在 8 或 9 年时 EWL 超过 50%。在 EWL 超过 50%的 LSG 患者与其他患者之间，初始体重指数无显著差异（分别为 45.9kg/m2，范围 35.8-59.4 与 45.7kg/m2，范围 38.9-63.7；P =.70）。与其他患者相比，EWL 超过 50%的 LSG 患者在 1 年时的 EWL 显著增加（分别为 76%，范围 48-103%与 45%，范围 13-99%；P =.058）。