Shen Dijian, Ye Huan, Wang Yuedong, Ji Yun, Zhan Xiaoli, Zhu Jinhui
Department of General Surgery and Laparoscopic Center, Second Affiliated Hospital Zhejiang University College of Medicine, Hangzhou, People's Republic of China; Department of Thoracic Surgery, Zhejiang Cancer Hospital, Hangzhou People's Republic of China.
Clinical Medical School, Hangzhou Normal University, Hangzhou, People's Republic of China.
Surg Obes Relat Dis. 2014 May-Jun;10(3):432-7. doi: 10.1016/j.soard.2013.09.004. Epub 2013 Sep 20.
Laparoscopic greater curvature plication (LGCP) is a novel restrictive bariatric procedure that can reduce the gastric volume by infolding the gastric greater curvature without gastrectomy. The objective of this study was to describe the surgical technique of LGCP and validate the efficacy and safety of LGCP for the treatment of obesity in obese Chinese patients with a relatively low body mass index (BMI).
Twenty-two obese patients (mean age 33.8±6.0 years; mean BMI 37.0±7.0 kg/m(2)) underwent LGCP between September 2011 and September 2012. After dissecting the greater omentum and short gastric vessels, the gastric greater curvature plication with 2 rows of nonabsorbable suture was performed under the guidance of a 32-F bougie. The data were collected during follow-up examinations performed at 1, 3, 6, and 12 months postoperatively.
All procedures were performed laparoscopically. The mean operative time was 84.1 minutes (50-120 min), and the mean length of hospital stay was 3.8 days (2-10 d). There were no deaths or postoperative major complications that needed reoperation. The mean percentage of excess weight loss (%EWL) was 22.9%±6.9%, 38.6%±9.8%, 51.5%±13.5%, and 61.1%±15.9% at 1, 3, 6, and 12 months postoperatively. At 6 months, type 2 diabetes was in remission in 2 (50%) patients, hypertension in 1 (33.3%) patient, and dyslipidemia in 11 (78.6%) patients. Decreases in the index for homeostasis model assessment of insulin resistance (HOMA-IR) and in insulin and glucose concentrations were observed.
The early outcomes of LGCP as a novel treatment for obese Chinese with a relatively low BMI are satisfactory with respect to the effectiveness and low incidence of major complications. Additional long-term follow-up and prospective, comparative trials are still needed.
腹腔镜大弯折叠术（LGCP）是一种新型的限制性减肥手术，可通过折叠胃大弯而不进行胃切除术来减少胃容积。本研究的目的是描述LGCP的手术技术，并验证LGCP治疗体重指数（BMI）相对较低的肥胖中国患者肥胖症的有效性和安全性。
2011年9月至2012年9月期间，22例肥胖患者（平均年龄33.8±6.0岁；平均BMI 37.0±7.0kg/m²）接受了LGCP手术。在解剖大网膜和胃短血管后，在一根32F探条的引导下，用两排不可吸收缝线进行胃大弯折叠术。在术后1、3、6和12个月的随访检查中收集数据。
所有手术均通过腹腔镜进行。平均手术时间为84.1分钟（50-120分钟），平均住院时间为3.8天（2-10天）。无死亡病例或需要再次手术的术后严重并发症。术后1、3、6和12个月时，平均超重减轻百分比（%EWL）分别为22.9%±6.9%、38.6%±9.8%、51.5%±13.5%和61.1%±15.9%。6个月时，2例（50%）2型糖尿病患者病情缓解，1例（33.3%）高血压患者病情缓解，11例（78.6%）血脂异常患者病情缓解。观察到胰岛素抵抗稳态模型评估指数（HOMA-IR）以及胰岛素和血糖浓度降低。
LGCP作为一种治疗BMI相对较低的肥胖中国患者的新方法，其早期疗效在有效性和严重并发症低发生率方面令人满意。仍需要进行更多的长期随访以及前瞻性对比试验。
