Homerton University Hospital, Homerton Row, London, United Kingdom.
Surg Obes Relat Dis. 2012 Mar-Apr;8(2):140-4. doi: 10.1016/j.soard.2011.04.232. Epub 2011 Jun 12.
The surgical treatment of superobese patients (body mass index ≥50 kg/m(2)) with significant co-morbidities remains a challenge. We evaluated our outcomes after initial laparoscopic sleeve gastrectomy (LSG) in the superobese undergoing staged procedures in the setting of a university hospital in the United Kingdom.
The data from patients with a body mass index of ≥50 kg/m(2) undergoing LSG as a part of a staged procedure from 2005 to 2008 were extracted from our database. The patient parameters were analyzed, along with the morbidity, length of stay, and weight loss after the initial procedure.
A total of 61 patients with a body mass index of ≥50 kg/m(2) (median 60, range 50-81.5) underwent LSG as a part of a staged procedure during the study period. The median age was 46 years (range 24-61.5), and 41 were women. Obesity-related co-morbidities were present in different combinations in 51 patients (83.6%). All the procedures were completed laparoscopically, barring 1. The median hospital stay was 4 days (interquartile range 3-4). Complications occurred in 6 patients (9.8%), and 3 required repeat laparoscopy for complications. No patient died. The median percentage of excess weight loss was 31% at 6 months (interquartile range 26-40) and 39% at 1 year (interquartile range 34-51). Diabetes, obstructive sleep apnea and hypertension had resolved in 90%, 100%, and 61% of the patients, respectively. Of the 61 patients, 41 went on to undergo a second-stage procedure, of whom 1 underwent laparoscopic Roux-en-Y gastric bypass, 5 underwent repeat LSG, and the rest underwent laparoscopic duodenal switch.
LSG is safe and effective for initial weight loss in the superobese undergoing 2-stage procedures.
对于合并有显著合并症的超级肥胖患者（体重指数≥50kg/m²），手术治疗仍然是一个挑战。我们评估了在英国一家大学医院中，对超级肥胖患者进行两阶段手术时，初次腹腔镜袖状胃切除术（LSG）的治疗效果。
从我们的数据库中提取了 2005 年至 2008 年期间，BMI≥50kg/m²的患者行 LSG 作为分阶段手术的一部分的数据。分析了患者的参数，以及初次手术后的发病率、住院时间和体重减轻情况。
在研究期间，共有 61 例 BMI≥50kg/m²的患者（中位数为 60，范围为 50-81.5）行 LSG 作为分阶段手术的一部分。中位年龄为 46 岁（范围 24-61.5），其中 41 例为女性。51 例患者（83.6%）存在不同组合的肥胖相关合并症。所有手术均经腹腔镜完成，仅有 1 例患者除外。中位住院时间为 4 天（四分位间距 3-4）。6 例患者（9.8%）发生并发症，其中 3 例需要再次腹腔镜手术治疗并发症。无患者死亡。6 个月时，中位超重体重减轻百分比为 31%（四分位间距 26-40），1 年时为 39%（四分位间距 34-51）。糖尿病、阻塞性睡眠呼吸暂停和高血压在 90%、100%和 61%的患者中得到缓解。在 61 例患者中，有 41 例继续进行第二阶段手术，其中 1 例行腹腔镜 Roux-en-Y 胃旁路术，5 例行重复 LSG，其余行腹腔镜十二指肠转位术。
LSG 是超级肥胖患者进行两阶段手术时安全有效的初始减重方法。
