Division of Upper GI Surgery, Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China.
Obes Surg. 2012 Nov;22(11):1742-5. doi: 10.1007/s11695-012-0725-x.
Prader-Willi syndrome (PWS) is a chromosomal disorder characterized by the presence of hyperghrelinemia, hyperphagia, and obesity. The optimal treatment for PWS patient remains controversial. Here, we present our experience of treating PWS with laparoscopic mini-gastric bypass (LMGBP) and laparoscopic sleeve gastrectomy (LSG). Three patients with genetic diagnosis of PWS and body mass index (BMI) greater than 40 kg/m(2) were referred for bariatric surgery. All of them had completed 2-year postoperative follow-up. Body weight, BMI, and ghrelin levels were recorded before and after surgery. They were two females and one male. Their age ranged from 15 to 23 years old, and the mean BMI was 46.7 kg/m(2) (range 44-50). Two patients underwent LSG and one patient underwent LMGBP. After a median follow-up of 33 months (range 24-36 months), mean weight loss and percentage of excessive weight loss at 2 years were 32.5 kg (24.9-38.3 kg) and 63.2 % (range 50.5-86.2 %), respectively. The mean fasting active ghrelin level decreased from 1,134.2 pg/ml preoperatively to 519.8 pg/ml 1 year after surgery. No major complication was observed. Iron deficiency anemia was observed in the patient who underwent LMGBP. Significant reduction of body weight and level of serum ghrelin can be achieved with minimal morbidity by LSG or LMGBP in patients with PWS.
普拉德-威利综合征（PWS）是一种染色体疾病，其特征为高胃饥饿素血症、多食和肥胖。PWS 患者的最佳治疗方法仍存在争议。本文报告了我们采用腹腔镜迷你胃旁路术（LMGBP）和腹腔镜袖状胃切除术（LSG）治疗 PWS 的经验。3 名基因诊断为 PWS 且 BMI 大于 40kg/m²的患者接受了减重手术。所有患者均完成了 2 年的术后随访。记录了手术前后的体重、BMI 和胃饥饿素水平。他们均为女性，年龄 15-23 岁，平均 BMI 为 46.7kg/m²（范围 44-50）。2 名患者行 LSG，1 名患者行 LMGBP。中位随访 33 个月（范围 24-36 个月）后，2 年时的平均减重和超重百分比分别为 32.5kg（24.9-38.3kg）和 63.2%（范围 50.5-86.2%）。空腹活性胃饥饿素水平从术前的 1134.2pg/ml 降至术后 1 年的 519.8pg/ml。未观察到主要并发症。行 LMGBP 的患者出现缺铁性贫血。LSG 或 LMGBP 可使 PWS 患者的体重和血清胃饥饿素水平显著降低，且发病率低。
