Department of General Surgery, Golestan University of Medical Sciences, Gorgan, Iran.
Obes Surg. 2013 Jan;23(1):87-92. doi: 10.1007/s11695-012-0777-y.
Demand for feasible, safe, and preferably low-cost methods of weight reduction is rising every day. The present study reports findings from laparoscopic gastric plication (LGP), which is a new restrictive bariatric technique, combined with a postoperative follow-up program. A 2-year prospective study was performed following LGP in 53 female morbidly obese patients from Gorgan, Iran, with a mean age of 36.3 years and mean body mass index (BMI) of 42.6 kg/m(2) (35.3-62.4). Through a four-port approach, the greater omentum and short gastric vessels were transected and the greater curvature was imbricated into the body of the stomach with two rows of nonabsorbable sutures. After surgery, all patients were scheduled to attend a weekly group meeting for behavioral modification and psychotherapy. The mean operative time and hospital stay was 95 min and 72 h, respectively. No intraoperative complications occurred. Mean percentages of excess weight loss (%EWL) were 25.6 %, 54.2 %, 70.2 %, and 74.4 % after 1, 6, 12, and 24 months, respectively. Six patients lost >84 % of their excess weight after 24 months. Patients who did not participate in the group meetings had a lower %EWL after 12 (79.5 % vs. 55.6 %) and 24 months (90 % vs. 43.4 %) compared with the patients who regularly participated in the group meetings (P < 0.005). LGP is a feasible, safe, and effective surgical method for weight loss for at least 24 months when performed on morbidly obese patients. Postoperative group meetings (POGM) for psychotherapy and behavioral modification helped patients to achieve better results.
对可行、安全、且最好是低成本减重方法的需求日益增长。本研究报告了腹腔镜胃折叠术（LGP）的研究结果，LGP 是一种新的限制型减重技术，结合术后随访方案。在伊朗戈尔甘对 53 名病态肥胖女性患者进行了为期 2 年的前瞻性研究，患者的平均年龄为 36.3 岁，平均体重指数（BMI）为 42.6kg/m²（35.3-62.4）。通过四孔入路，横断大网膜和短胃血管，并将胃大弯用两排不可吸收缝线折叠到胃体。手术后，所有患者均安排参加每周一次的行为修正和心理治疗小组会议。平均手术时间和住院时间分别为 95 分钟和 72 小时。无术中并发症。术后 1、6、12 和 24 个月时，体重多余部分的平均减轻百分比（%EWL）分别为 25.6%、54.2%、70.2%和 74.4%。24 个月后，有 6 名患者的体重减轻超过 84%。与定期参加小组会议的患者相比，不参加小组会议的患者在 12 个月（79.5% vs. 55.6%）和 24 个月（90% vs. 43.4%）时的%EWL 更低（P<0.005）。对于病态肥胖患者，LGP 是一种可行、安全且有效的减重手术方法，至少可维持 24 个月。术后小组会议（POGM）可进行心理治疗和行为修正，帮助患者获得更好的效果。
