Département de Chirurgie, Division de Chirurgie Bariatrique, Hôpital du Sacré-Coeur de Montréal, Université de Montréal, 5400 boul. Gouin ouest Montréal, Québec, H4J 1C5, Canada.
Obes Surg. 2013 Sep;23(9):1397-403. doi: 10.1007/s11695-013-0934-y.
Laparoscopic gastric greater curvature plication (LGGCP) is a new restrictive weight loss procedure.
Between February 2011 and June 2012, 57 patients underwent LGGCP. Thirteen had it associated with a lap band and were excluded from the study. Data was collected through routine follow-up. Demographics, complications, and percentage of excess weight loss (% EWL) were determined.
Forty-four patients underwent LGGCP, 40 women and 4 men with a mean age of 40 years (range, 18-72), a mean body mass index of 38 kg/m(2) (range, 35-46). Comorbidities included 2 diabetes mellitus, 11 hypertension, 8 hyperlipidaemia, and 8 obstructive sleep apnea. The mean operative time was 106 min (range, 60-180) and mean duration of hospital stay was 18 h (range, 12-168). Operative complications included one subphrenic abscess, one gastrogastric hernia, and one acute respiratory distress syndrome. Thirty patients experienced strong restriction with nausea and vomiting for the first 10 days (79.5 %). Eleven patients (25.0 %) came back with intractable nausea and vomiting, and were hospitalized, or had their hospital stay prolonged. Four patients needed early reversal of gastric plication (9 %). There was no postoperative death. The mean postoperative % EWL was 30.6 % (n = 40), 57.0 % (n = 24), 50.7 % (n = 13) at 1, 6, and 12 months, respectively.
LGGCP yields an acceptable weight loss compared to other restrictive procedures, but with a higher readmission rate for postoperative nausea and vomiting, or even reversal of plication. We advocate more studies to evaluate safety and effectiveness.
腹腔镜胃大弯折叠术（LGGCP）是一种新的限制性减肥手术。
2011 年 2 月至 2012 年 6 月，57 例患者接受了 LGGCP。其中 13 例与胃带联合进行，因此被排除在研究之外。通过常规随访收集数据。确定了人口统计学、并发症和体重减轻百分比（%EWL）。
44 例患者接受了 LGGCP，其中 40 例为女性，4 例为男性，平均年龄为 40 岁（范围，18-72 岁），平均体重指数为 38kg/m2（范围，35-46）。合并症包括 2 型糖尿病、11 例高血压、8 例高脂血症和 8 例阻塞性睡眠呼吸暂停。手术时间平均为 106 分钟（范围，60-180 分钟），平均住院时间为 18 小时（范围，12-168 小时）。手术并发症包括膈下脓肿 1 例、胃胃疝 1 例和急性呼吸窘迫综合征 1 例。30 例患者在最初 10 天出现强烈的限制和恶心呕吐（79.5%）。11 例（25.0%）患者因难治性恶心呕吐而返回，需要住院或延长住院时间。4 例患者需要早期反转胃折叠（9%）。术后无死亡。40 例患者术后平均%EWL 为 30.6%（n=40），24 例患者分别为 57.0%（n=24）、50.7%（n=13），分别为术后 1、6 和 12 个月。
与其他限制性手术相比，LGGCP 可获得可接受的减重效果，但术后恶心呕吐的再入院率较高，甚至需要反转折叠。我们提倡进行更多的研究来评估安全性和有效性。
