Jackson Timothy D, Hutter Matthew M
Center for Clinical Effectiveness in Surgery, Massachusetts General Hospital, Boston, MA 02114, USA.
Adv Surg. 2012;46:255-68. doi: 10.1016/j.yasu.2012.05.002.
LSG, LAGB, and LRYGB are all safe and effective modern surgical options for the treatment of morbid obesity. Recent quality improvement successes in bariatric surgical care delivery have resulted in low mortality and morbidity after these procedures. All seem to result in sustained weight loss and improvement in weight-related comorbidities, although appropriate long-term outcomes data for all procedure types are needed. The LRYGB seems to be associated with the most risk but offers the most benefit, whereas the LAGB seems to have the lowest risk and to be least effective. The LSG seems to be positioned between the LRYGB and LAGB in associated morbidity and effectiveness in short-term and medium-term studies. Because the LSG has only recently been performed, there are currently no data about its long-term effectiveness. A better understanding of the unique risk/benefit profile associated with each procedure type will better inform patient selection and has the potential to further optimize outcomes.
腹腔镜袖状胃切除术（LSG）、腹腔镜可调节胃束带术（LAGB）和腹腔镜Roux-en-Y胃旁路术（LRYGB）都是治疗病态肥胖的安全有效的现代手术选择。近期减肥手术护理质量的改善成果使这些手术的死亡率和发病率降低。所有这些手术似乎都能带来持续的体重减轻，并改善与体重相关的合并症，不过所有手术类型都需要合适的长期疗效数据。LRYGB似乎风险最高，但益处也最大，而LAGB似乎风险最低且效果最差。在短期和中期研究中，LSG在相关发病率和有效性方面似乎介于LRYGB和LAGB之间。由于LSG是最近才开展的手术，目前尚无关于其长期有效性的数据。更好地了解每种手术类型所特有的风险/益处情况将有助于更好地进行患者选择，并有可能进一步优化治疗效果。
