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腹腔镜袖状胃切除术短期随访后显著体重减轻和糖尿病及血脂异常迅速缓解。

Significant weight loss and rapid resolution of diabetes and dyslipidemia during short-term follow-up after laparoscopic sleeve gastrectomy.

机构信息

Department of Visceral, Transplant and Thoracic Surgery, Center of Operative Medicine, Innsbruck Medical University, Anichstr. 35, 6020, Innsbruck, Austria,

出版信息

Obes Surg. 2013 Dec;23(12):1966-72. doi: 10.1007/s11695-013-1038-4.

Abstract

BACKGROUND

Bariatric surgery has been established as the best option of treatment for morbid obesity. Recently, laparoscopic sleeve gastrectomy (SG) has become very popular because of good postoperative weight loss and low morbidity. The aim of this study was to report our single-center experience with SG regarding feasibility, morbidity, and outcome.

METHODS

From January 2006 to December 2011, 93 patients (68 female) with a median age of 46 years underwent laparoscopic SG at our department. Thirteen patients had a history of gastric banding with insufficient weight loss or band-related complications. Clinical outcome and laboratory findings were analyzed.

RESULTS

The mean preoperative and postoperative body mass index (BMI) was 44.1 ± 6.9 and 33.4 ± 6.8 kg/m(2), respectively (p < 0.001). The mean excessive body weight loss after a median follow-up of 11.9 months was 55.7 % ± 24.9 %. Three bleedings, two staple line leakages, and a deep wound infection required conversion to laparotomy (n = 1), reoperation (n = 4), or endoscopic stent implantation (n = 2). Resolution of diabetes and dyslipidemia was seen in 85 and 50 % of patients, respectively. Blood test results of HbA1c, cholesterols, triglycerides, and leptin showed significant postoperative improvement.

CONCLUSIONS

Laparoscopic SG represents a feasible bariatric procedure with good short-term weight loss, low morbidity rate, and efficient resolution of diabetes and dyslipidemia, especially in patients with lower BMI. The significant decrease of leptin necessitates further studies to understand the ambiguous role of leptin in bariatric surgery.

摘要

背景

减重手术已被确立为治疗病态肥胖的最佳选择。最近,腹腔镜袖状胃切除术(SG)由于术后体重减轻效果好且发病率低而变得非常流行。本研究旨在报告我们单中心行 SG 的经验,包括可行性、发病率和结果。

方法

自 2006 年 1 月至 2011 年 12 月,我院 93 例(68 例女性)患者接受了腹腔镜 SG,中位年龄为 46 岁。其中 13 例患者有胃带病史,存在减重不足或与带相关的并发症。分析临床结果和实验室检查结果。

结果

术前和术后的平均体重指数(BMI)分别为 44.1±6.9kg/m²和 33.4±6.8kg/m²(p<0.001)。在中位随访 11.9 个月后,平均超重体重减轻率为 55.7%±24.9%。3 例出血、2 例吻合口漏和 1 例深部伤口感染需要转为剖腹手术(n=1)、再次手术(n=4)或内镜支架植入(n=2)。85%和 50%的患者分别出现糖尿病和血脂异常缓解。HbA1c、胆固醇、甘油三酯和瘦素的血液检查结果显示术后显著改善。

结论

腹腔镜 SG 是一种可行的减重手术,具有良好的短期减重效果、低发病率和有效解决糖尿病和血脂异常的效果,尤其是 BMI 较低的患者。瘦素的显著下降需要进一步的研究来了解瘦素在减重手术中的作用。

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