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腹腔镜迷你胃旁路手术的疗效与安全性:一项系统评价

Efficacy and safety of laparoscopic mini gastric bypass. A systematic review.

作者信息

Georgiadou Despoina, Sergentanis Theodoros N, Nixon Alexander, Diamantis Theodoros, Tsigris Christos, Psaltopoulou Theodora

机构信息

3(rd) Surgical Clinic of George Gennimatas General Hospital, Athens, Greece; Postgraduate Program "Minimally Invasive Surgery, Robotic Surgery and Telesurgery," National and Kapodistrian University of Athens, School of Medicine, Athens, Greece.

Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, University of Athens, Athens, Greece.

出版信息

Surg Obes Relat Dis. 2014 Sep-Oct;10(5):984-91. doi: 10.1016/j.soard.2014.02.009. Epub 2014 Feb 15.

Abstract

BACKGROUND

Laparoscopic mini-gastric bypass (LMGB) is a relatively new bariatric procedure; published studies are accumulating in various settings. The objective of this study was to summarize the available evidence about the efficacy and safety of LMGB.

METHODS

A systematic search in the literature was performed , and PubMed and reference lists were scrutinized (end-of-search date: July 15, 2013). For the assessment of the eligible articles, the Newcastle-Ottawa quality assessment scale was used.

RESULTS

Ten eligible studies were included in this study, reporting data on 4,899 patients. According to all included studies, LMGB induced substantial weight and body mass index reduction, as well as substantial excess weight loss. Moreover, resolution or improvement in all major associated medical illnesses and improvement in overall Gastrointestinal Quality of Life Index score were recorded. Major bleeding and anastomotic ulcer were the most commonly reported complications. Readmission rate ranged from 0%- 11%, whereas the rate of revision operations ranged from .3%- 6%. The latter were conducted due to a variety of medical reasons such as inadequate or excessive weight loss, malnutrition, and upper gastrointestinal bleeding. Finally, the mortality rate ranged between 0% and .5% among primary LMGB procedures.

CONCLUSION

LMGB represents an effective bariatric procedure; its safety and minimal postoperative morbidity seem remarkable. Randomized comparative studies seem mandatory for the further evaluation of LMGB.

摘要

背景

腹腔镜迷你胃旁路术(LMGB)是一种相对较新的减肥手术;在各种情况下发表的研究不断积累。本研究的目的是总结关于LMGB疗效和安全性的现有证据。

方法

对文献进行系统检索,并仔细查阅了PubMed及参考文献列表(检索截止日期:2013年7月15日)。采用纽卡斯尔-渥太华质量评估量表对符合条件的文章进行评估。

结果

本研究纳入了10项符合条件的研究,报告了4899例患者的数据。根据所有纳入研究,LMGB可显著减轻体重和降低体重指数,以及实现显著的超重减轻。此外,所有主要相关内科疾病均得到缓解或改善,胃肠道生活质量指数总分也有所提高。大出血和吻合口溃疡是最常报告的并发症。再入院率为0%-11%,而翻修手术率为0.3%-6%。翻修手术是由于各种医学原因进行的,如体重减轻不足或过度、营养不良和上消化道出血。最后,初次LMGB手术的死亡率在0%至0.5%之间。

结论

LMGB是一种有效的减肥手术;其安全性和极低的术后发病率似乎很显著。随机对照研究对于进一步评估LMGB似乎是必要的。

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