肥胖、病态肥胖及超级病态肥胖患者的腹腔镜袖状胃切除术经验。

An experience of laparoscopic sleeve gastrectomy in obese, morbidly obese, and super morbid obese patients.

作者信息

Al Falah Haitham M, AlSalamah Saleh M, Abdullah Muhammad, AlQahtani Hamad H, Abbas Ghanem S, AlSalamah Yasir A

机构信息

Department of Surgery, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia.

出版信息

Saudi Med J. 2013 May;34(5):503-10.

PMID:23677267

Abstract

OBJECTIVE

To report experience with laparoscopic sleeve gastrectomy (LSG) in obese, morbidly obese, and super morbid obese patients, and to evaluate comparative efficacy of LSG among these patient groups.

METHODS

A total of 147 patients underwent LSG between March 2008 and December 2011 at the Department of Surgery, King Saud Medical City, Riyadh, Kingdom of Saudi Arabia. Patients were grouped according to the preoperative body mass index (BMI) into obese (35-39.9 kg/m2), morbidly obese (40-49.9 kg/m2), and super morbid obese (>50 kg/m2). Patients who did not have a regular follow-up (n=38) were excluded, and 108 patients were included in this prospective study.

RESULTS

The mean total weight loss (TWL) among the super morbid obese group (41.31 +/- 21.23 kg) was statistically significantly greater compared to the obese group (24.31 +/- 13.00 kg, p=0.009) and morbidly obese group (26.81 +/- 15.56 kg, p=0.001). The mean percentage excess weight loss (EWL) was clinically significant among obese (57.8%), morbidly obese (42.5%), and super morbid obese patients (45.7%), however, it was not statistically significant between the groups (F[2,105]=2.132, p=0.124). There was no mortality; however, 6 major complications occurred including intra-abdominal collection with suspected leak, staple line bleeding, bowel ischemia, and inferior vena cava injury.

CONCLUSION

Laparoscopic sleeve gastrectomy resulted in satisfactory and effective EWL in all 3 groups of obesity patients at 30-months follow-up.

摘要

目的

报告腹腔镜袖状胃切除术（LSG）在肥胖、病态肥胖和超级病态肥胖患者中的应用经验，并评估LSG在这些患者群体中的相对疗效。

方法

2008年3月至2011年12月期间，沙特阿拉伯利雅得国王沙特医疗城外科共147例患者接受了LSG。根据术前体重指数（BMI）将患者分为肥胖组（35 - 39.9 kg/m²）、病态肥胖组（40 - 49.9 kg/m²）和超级病态肥胖组（>50 kg/m²）。未进行定期随访的患者（n = 38）被排除，108例患者纳入本前瞻性研究。

结果

超级病态肥胖组的平均总体重减轻（TWL）（41.31±21.23 kg）与肥胖组（24.31±13.00 kg，p = 0.009）和病态肥胖组（26.81±15.56 kg，p = 0.001）相比，在统计学上显著更高。肥胖组（57.8%）、病态肥胖组（42.5%）和超级病态肥胖患者（45.7%）的平均超重体重减轻百分比（EWL）具有临床意义，然而，组间差异无统计学意义（F[2,105]=2.132，p = 0.124）。无死亡病例；然而，发生了6例主要并发症，包括腹腔内积液伴疑似渗漏、吻合钉线出血、肠缺血和下腔静脉损伤。