First Faculty of Medicine, Charles University, Katerinska 32, 128 00 Prague 2, Czech Republic.
Obes Surg. 2012 Aug;22(8):1298-307. doi: 10.1007/s11695-012-0684-2.
Laparoscopic greater curvature plication (LGCP) is a new metabolic/bariatric surgical procedure that requires no resection, bypass, or implantable device. We report LGCP outcomes in 244 morbidly obese patients.
Between 2010 and 2011, patients underwent LGCP. Body mass index (BMI, kilogram per square meter) evolution, excess BMI loss (%EBMIL), excess weight loss (%EWL), complications, and type 2 diabetes mellitus (T2DM) changes were recorded. Repeated-measures analysis of variance (ANOVA) was used to assess weight change at 6, 12, and 18 months. Subgroup analyses were conducted to provide benchmark outcomes at 6 months. Logistic regression was used to identify characteristics predictive of suboptimal weight loss.
Mean baseline BMI (±SD) was 41.4 ± 5.5 (80.7 % women, mean age 46.1 ± 11.0 years, 68 [27.9 %] patients had T2DM). Mean operative time was 70.6 min; mean hospitalization, 36 h (24-72). Sixty-eight patients (27.9 %) experienced postoperative nausea and/or vomiting that was controlled within 36 h. There was no mortality. Major complication rate was 1.2 % (n = 3). Repeated-measures ANOVA indicated significant weight loss across time points (p < 0.001). At 6 months (n = 105), BMI, %EBMIL, and %EWL were 36.1 ± 4.7, 34.8 ± 17.3, and 31.8 ± 15.9. Preoperative BMI was the only predictor of weight loss. Patients with BMI <40 lost more weight than those ≥40, although by 9 months, differences were no longer significant. In patients with preoperative BMI <40, 18-month %EWL approached 50 % and %EBMIL exceeded 50 %. At 6 months, 96.9 % of patients' T2DM was significantly improved/resolved.
Over the short term, LGCP results in effective weight loss and significant T2DM reduction with a very low rate of complications.
腹腔镜胃大弯折叠术（LGCP）是一种新的代谢/减重手术，无需切除、旁路或植入装置。我们报告了 244 例病态肥胖患者的 LGCP 结果。
在 2010 年至 2011 年期间，患者接受了 LGCP。记录体重指数（BMI，千克/平方米）变化、多余 BMI 减轻率（%EBMIL）、多余体重减轻率（%EWL）、并发症和 2 型糖尿病（T2DM）变化。采用重复测量方差分析（ANOVA）评估 6、12 和 18 个月时的体重变化。进行亚组分析以提供 6 个月时的基准结果。采用逻辑回归确定预测体重减轻不理想的特征。
平均基线 BMI（±SD）为 41.4±5.5（80.7%女性，平均年龄 46.1±11.0 岁，68 [27.9%]例患者患有 T2DM）。平均手术时间为 70.6 分钟；平均住院时间 36 小时（24-72 小时）。68 例（27.9%）患者术后出现恶心和/或呕吐，36 小时内得到控制。无死亡病例。主要并发症发生率为 1.2%（n=3）。重复测量 ANOVA 表明各时间点体重明显减轻（p<0.001）。6 个月（n=105）时，BMI、%EBMIL 和 %EWL 分别为 36.1±4.7、34.8±17.3 和 31.8±15.9。术前 BMI 是体重减轻的唯一预测因素。BMI<40 的患者比 BMI≥40 的患者减重更多，但到 9 个月时，差异不再显著。在术前 BMI<40 的患者中，18 个月时的 EWL 接近 50%，EBMIL 超过 50%。6 个月时，96.9%的患者 T2DM 显著改善/解决。
短期内，LGCP 可有效减轻体重，显著降低 2 型糖尿病的发病率，且并发症发生率非常低。
