腹腔镜袖状胃切除术与腹腔镜可调胃束带术治疗病态肥胖的比较：荟萃分析。

Comparison between laparoscopic sleeve gastrectomy and laparoscopic adjustable gastric banding for morbid obesity: a meta-analysis.

机构信息

College of Basic Medicine, Nanjing Medical University, Nanjing, 211166, People's Republic of China.

出版信息

Obes Surg. 2013 Jul;23(7):980-6. doi: 10.1007/s11695-013-0893-3.

DOI:10.1007/s11695-013-0893-3

PMID:23604584

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3671102/

Abstract

Bariatric surgery is now widely accepted for treatment of morbid obesity. This study compared the effects of laparoscopic sleeve gastrectomy (LSG) and laparoscopic adjustable gastric banding (LAGB) on excess weight loss (EWL) and type 2 diabetes mellitus (T2DM). PubMed and Embase were searched for publications concerning LAGB and LSG from 2000 to 2012, with the last search on August 17, 2012. EWL and T2DM improvement over 6 and 12 months were pooled and compared by meta-analysis. Odds ratios (ORs) and mean differences were calculated with 95 % confidence intervals (CIs). Eleven studies involving 1,004 patients met the inclusion criteria. Compared with LAGB, LSG achieved greater EWL. The mean percentage EWL for LAGB was 33.9 % after 6 months in six studies and 37.8 % after 12 months in four studies; for LSG, EWL was 50.6 % after 6 months and 51.8 % after 12 months in the same studies. LSG was also superior to LAGB in treating T2DM. In five studies, T2DM was improved in 42 of 68 (61.8 %) patients after LAGB and 66 of 80 (82.5 %) after LSG, representing a pooled OR of 0.34 (95 % CI 0.16-0.73) and pooled mean differences of -12.55 (95 % CI -15.66 to -9.43) and -4.97 (95 % CI -7.58 to -8.36), respectively. LSG is more effective than LAGB in morbid obesity, with higher percentage EWL and greater improvement in T2DM.

摘要

减重手术目前被广泛接受用于治疗病态肥胖。本研究比较了腹腔镜胃袖状切除术（LSG）和腹腔镜可调胃束带术（LAGB）对多余体重减轻（EWL）和 2 型糖尿病（T2DM）的影响。我们检索了从 2000 年至 2012 年发表的有关 LAGB 和 LSG 的文献，最后检索日期为 2012 年 8 月 17 日。通过荟萃分析比较了 6 个月和 12 个月时 EWL 和 T2DM 的改善情况。用 95 %置信区间（CI）计算了比值比（OR）和均数差值。11 项研究共纳入 1004 例患者符合纳入标准。与 LAGB 相比，LSG 实现了更大的 EWL。6 项研究中 LAGB 术后 6 个月的平均 EWL 百分比为 33.9 %，4 项研究中 12 个月时为 37.8 %；LSG 术后 6 个月和 12 个月的 EWL 分别为 50.6 %和 51.8 %。LSG 在治疗 T2DM 方面也优于 LAGB。在 5 项研究中，LAGB 后 T2DM 改善的患者为 68 例中的 42 例（61.8 %），LSG 后为 80 例中的 66 例（82.5 %），合并 OR 为 0.34（95 % CI 0.16-0.73），合并均数差值为-12.55（95 % CI-15.66 至-9.43）和-4.97（95 % CI-7.58 至-8.36）。LSG 在病态肥胖方面比 LAGB 更有效，EWL 百分比更高，T2DM 改善更大。