Department of Surgery, Catharina Hospital, PO Box 1350, 5602 ZA, Eindhoven, The Netherlands.
Br J Surg. 2014 May;101(6):661-8. doi: 10.1002/bjs.9447.
Sleeve gastrectomy is being performed increasingly in Europe. Data on long-term outcome would be helpful in defining the role of sleeve gastrectomy. The aim of this study was to evaluate the outcome of sleeve gastrectomy as a primary bariatric procedure.
Medical charts of all patients who underwent a primary sleeve gastrectomy at the authors' institution between August 2006 and December 2012 were reviewed retrospectively using a prospective online data registry. For evolution of weight loss and co-morbidity, only patients with follow-up of at least 1 year were included. A subgroup analysis was done to compare patients with an intended stand-alone procedure and those with an intended two-stage procedure.
A total of 1041 primary sleeve gastrectomies were performed in the study period. Median duration of surgery was 47 min, and median hospital stay was 2 days. Intra-abdominal bleeding occurred in 27 patients (2·6 per cent) and staple-line leakage in 24 (2.3 per cent). Some 866 patients had at least 1 year of follow-up. Mean excess weight loss was 68.4 per cent after 1 year (P < 0.001) and 67.4 per cent after 2 years. Smaller groups of patients achieved a mean excess weight loss of 69.3 per cent (163 patients), 70.5 per cent (62) and 58.3 per cent (19) after 3, 4 and 5 years respectively. No difference in postoperative complications was found between the subgroups. Seventy-one (8.2 per cent) of 866 patients had a revision of the sleeve gastrectomy; reflux or dysphagia was the indication in 34 (48 per cent) of these patients.
Sleeve gastrectomy is a safe and effective bariatric procedure. Maximum weight loss was achieved after 4 years. Long-term results regarding weight loss and co-morbidities were satisfactory.
袖状胃切除术在欧洲的应用日益增多。长期结果数据有助于确定袖状胃切除术的作用。本研究旨在评估袖状胃切除术作为主要减肥手术的效果。
回顾性分析 2006 年 8 月至 2012 年 12 月期间在作者所在机构接受初次袖状胃切除术的所有患者的病历，使用前瞻性在线数据登记系统进行。对于体重减轻和合并症的演变，仅纳入随访时间至少 1 年的患者。进行了亚组分析，以比较旨在单独进行的手术和旨在两阶段进行的手术的患者。
在研究期间共进行了 1041 例初次袖状胃切除术。手术的中位时间为 47 分钟，中位住院时间为 2 天。27 例（2.6%）发生腹腔内出血，24 例（2.3%）发生吻合口漏。866 例患者中有至少 1 年的随访。术后 1 年平均超重减轻 68.4%（P<0.001），术后 2 年减轻 67.4%。较小的患者组分别在 3、4 和 5 年后达到平均超重减轻 69.3%（163 例）、70.5%（62 例）和 58.3%（19 例）。两个亚组之间术后并发症无差异。866 例患者中有 71 例（8.2%）行袖状胃切除术修正术；其中 34 例（48%）的指征为反流或吞咽困难。
袖状胃切除术是一种安全有效的减肥手术。4 年后达到最大减重效果。长期结果显示，体重减轻和合并症的效果令人满意。
