Bariatric and Metabolic Institute, Cleveland Clinic Florida, Weston, FL 33331, USA.
Obes Surg. 2012 Apr;22(4):555-9. doi: 10.1007/s11695-011-0574-z.
Laparoscopic sleeve gastrectomy is a viable option that is becoming common in the management of morbid obesity. The aim of this study was to examine the effectiveness and safety of laparoscopic sleeve gastrectomy as a primary step for rapid weight loss in patients who required a second non-bariatric procedure.
After Internal Review Board approval and with adherence to HIPAA guidelines, we conducted a retrospective review of a prospectively collected database of all patients who underwent laparoscopic sleeve gastrectomy as a primary procedure for a second non-bariatric operation from November 2004 to September 2008 at the Bariatric and Metabolic Institute at Cleveland Clinic Florida. The data was reviewed for age, gender, percentage of excess weight loss (%EWL), preoperative and postoperative body mass index (BMI), morbidity, and mortality. Mean follow-up time was 7 months (range, 2 weeks-12 months).
Laparoscopic sleeve gastrectomy was performed in 18 patients who needed a second non-bariatric procedure such as knee replacement surgery, recurrent incisional hernia repair, laminectomy of the lumbar spine, kidney transplant, anterior cervical discectomy, and nephrectomy. Mean preoperative weight and BMI were 124.9 kg (range, 95.5-172.3 kg) and 44.87 kg/m2 (range, 33.36-58.87 kg/m2), respectively. Mean postoperative weight and BMI were 99.2 kg (range, 68.2-132.2 kg) and 35.79 kg/m2 (range, 23.46-48.97 kg/m2), respectively. There were no conversions to an open procedure in this series. There was no morbidity or mortality in this series.
In this small group, laparoscopic sleeve gastrectomy appears to be an effective and safe first surgical approach for rapid weight loss in high-risk patients that require a second non-bariatric procedure.
腹腔镜袖状胃切除术是一种可行的选择，在肥胖症的治疗中越来越普遍。本研究旨在检查腹腔镜袖状胃切除术作为快速减肥的主要步骤的有效性和安全性，这些患者需要进行第二次非减肥手术。
经内部审查委员会批准并遵守 HIPAA 指南，我们对 2004 年 11 月至 2008 年 9 月克利夫兰诊所佛罗里达州减重和代谢研究所进行的前瞻性收集数据库中所有接受腹腔镜袖状胃切除术作为第二次非减肥手术的主要手术的患者进行了回顾性审查。审查了年龄、性别、超重减轻百分比 (%EWL)、术前和术后体重指数 (BMI)、发病率和死亡率。平均随访时间为 7 个月（范围，2 周至 12 个月）。
腹腔镜袖状胃切除术在 18 名需要进行第二次非减肥手术的患者中进行，这些手术包括膝关节置换术、复发性切口疝修复术、腰椎减压术、肾移植、前路颈椎间盘切除术和肾切除术。平均术前体重和 BMI 分别为 124.9kg（范围，95.5-172.3kg）和 44.87kg/m2（范围，33.36-58.87kg/m2）。平均术后体重和 BMI 分别为 99.2kg（范围，68.2-132.2kg）和 35.79kg/m2（范围，23.46-48.97kg/m2）。本系列中无转换为开放手术。本系列中无发病率或死亡率。
在这个小群体中，腹腔镜袖状胃切除术似乎是一种有效且安全的初次手术方法，适用于需要第二次非减肥手术的高危患者快速减肥。
