Abdallah Emad, El Nakeeb Ayman, Youssef Tamer, Abdallah Hesham, Ellatif Mohamed Abd, Lotfy Ahmed, Youssef Mohamed, Elganash Abdelazeem, Moatamed Ahmed, Morshed Mosaad, Farid Mohammed
Surgical Department, Mansoura University, Mansoura, Egypt.
Obes Surg. 2014 Oct;24(10):1587-94. doi: 10.1007/s11695-014-1242-x.
Laparoscopic sleeve gastrectomy (LSG) is a surgical technique that treats morbid obesity.
Consecutive patients with morbid obesity treated by LSG at our department were evaluated. Patients enrolled in the study were randomized into group I (LSG begins the division 2 cm from the pylorus) and group II (LSG begins the division 6 cm from the pylorus). The primary outcome measure was the percent of excess weight loss (% EWL); secondary outcomes included postoperative morbidity and mortality and improvement of comorbidity.
One hundred five patients (79 (75.2 %) were females) were randomized into two groups of (GI) 52 patients and (GII) 53 patients. In group I, the mean % EWL was 51.8 ± 13.9, 63.8 ± 16.1 and 71.8 ± 12; however, in group II, the mean % EWL was 38.3 ± 10.9, 51.9 ± 13.6 and 61 ± 11.1 at 6, 12, and 24 months, respectively (P = 0.0001, 0.0001, 0.003). There was weight regain after 2 years in five patients in group II and only one patient in group I (P = 0.09). There was no significant difference between both group as regards gastric leakage, vomiting or GER. There was significant improvement in comorbidity after LSG in both groups, but no significant difference between them. Hospital mortality occurred in group II in one case as a result of gastric leakage.
LSG is a safe and effective procedure with good short-term outcome. Increasing the size of the resected antrum is associated with better weight loss without increasing the rate of complications significantly.
腹腔镜袖状胃切除术（LSG）是一种治疗病态肥胖症的外科技术。
对在我们科室接受LSG治疗的连续病态肥胖患者进行评估。纳入研究的患者被随机分为I组（LSG从距幽门2 cm处开始分割）和II组（LSG从距幽门6 cm处开始分割）。主要结局指标是超重减轻百分比（%EWL）；次要结局包括术后发病率、死亡率和合并症的改善情况。
105例患者（79例（75.2%）为女性）被随机分为两组，I组52例患者，II组53例患者。在I组中，6个月、12个月和24个月时的平均%EWL分别为51.8±13.9、63.8±16.1和71.8±12；然而，在II组中，6个月、12个月和24个月时的平均%EWL分别为38.3±10.9、51.9±13.6和61±11.1（P = 0.0001、0.0001、0.003）。II组有5例患者在2年后体重反弹，I组只有1例患者（P = 0.09）。两组在胃漏、呕吐或胃食管反流方面无显著差异。两组患者在LSG术后合并症均有显著改善，但两组之间无显著差异。II组有1例患者因胃漏发生医院死亡。
LSG是一种安全有效的手术，短期效果良好。增加切除胃窦的大小与更好的体重减轻相关，且不会显著增加并发症发生率。
