Abellan Israel, Luján Juan, Frutos Maria Dolores, Abrisqueta Jesus, Hernández Quiteria, López Victor, Parrilla Pascual
Department of General Surgery, Virgen de la Arrixaca University Hospital, University of Murcia, Murcia, Spain.
Department of General Surgery, Virgen de la Arrixaca University Hospital, University of Murcia, Murcia, Spain.
Surg Obes Relat Dis. 2014 Sep-Oct;10(5):829-33. doi: 10.1016/j.soard.2014.06.009. Epub 2014 Jul 23.
Roux-en-Y gastric bypass (RYGB) is considered the gold standard for the treatment of morbid obesity. There is no consensus over ideal limb length when the bypass is created and published studies do not take into account the influence of the common limb (CL) on weight loss. The objective was to study the influence of the common limb after RYGB. The setting was the Virgen de la Arrixaca University Clinical Hospital in Murcia, Spain.
This prospective study includes 151 patients undergoing laparoscopic RYGB surgery for morbid obesity. The patients were divided into 2 groups according to their body mass index. The small intestine (SI) was measured using micro forceps so that the percentage of common limb (%CL) could then be compared against the total SI in each patient. The percentage of excess weight loss (%EWL) in relation to the %CL was calculated at 3, 12, and 24 months. A series of tests was conducted simultaneously to analyze nutritional deficiencies and their relation to the %CL.
The total jejunoileal segment and the %CL in the groups of both obese and super-obese patients had no influence on the %EWL in either group for any of the periods studied. The patients with a %CL<50% had greater nutritional deficiencies in the follow-up period and required supplements and more frequent laboratory tests.
The %CL has no effect on weight loss in RYGB patients. A lower %CL is related to greater nutritional deficiencies.
Roux-en-Y胃旁路术（RYGB）被认为是治疗病态肥胖的金标准。在构建旁路时，对于理想的肠袢长度尚无共识，且已发表的研究未考虑共同肠袢（CL）对体重减轻的影响。目的是研究RYGB术后共同肠袢的影响。研究地点为西班牙穆尔西亚的阿瑞萨卡圣母大学临床医院。
这项前瞻性研究纳入了151例因病态肥胖接受腹腔镜RYGB手术的患者。根据体重指数将患者分为两组。使用微型镊子测量小肠（SI），以便将每位患者的共同肠袢百分比（%CL）与总SI进行比较。计算3个月、12个月和24个月时相对于%CL的超重减轻百分比（%EWL）。同时进行一系列测试以分析营养缺乏情况及其与%CL的关系。
在研究的任何时间段内，肥胖和超级肥胖患者组的空肠回肠总段和%CL对两组中的任何一组的%EWL均无影响。%CL<50%的患者在随访期间营养缺乏更严重，需要补充营养并更频繁地进行实验室检查。
%CL对RYGB患者的体重减轻没有影响。较低的%CL与更严重的营养缺乏有关。
