Lemanu Daniel P, Singh Primal P, Rahman Habib, Hill Andrew G, Babor Richard, MacCormick Andrew D
Department of Surgery, South Auckland Clinical School, University of Auckland, Auckland, New Zealand; Department of Surgery, Middlemore Hospital, Counties Manukau District Health Board, Auckland, New Zealand.
Department of Surgery, South Auckland Clinical School, University of Auckland, Auckland, New Zealand; Department of Surgery, Middlemore Hospital, Counties Manukau District Health Board, Auckland, New Zealand.
Surg Obes Relat Dis. 2015 May-Jun;11(3):518-24. doi: 10.1016/j.soard.2014.08.019. Epub 2014 Oct 2.
Whilst the early to mid-term efficacy of laparoscopic sleeve gastrectomy (SG) is well established, there is comparatively less detailing of long-term efficacy. The objectives of this study were to evaluate the long-term outcomes of patients undergoing SG at the authors' institution.
All patients undergoing SG during the past 5 or more years were eligible. Outcomes included baseline demographic data, preoperative characteristics, percentage excess weight loss (%EWL), co-morbidity improvement and resolution, serum hemoglobin A(1c) (HbA(1c)), serum lipid profile, and the Bariatric Analysis Reporting Outcome System (BAROS) questionnaire. A subset analysis was also performed with patients stratified in to super obese (body mass index ≥ 50 kg/m(2)).
There were 96 patients who underwent surgery between March 2007 and July 2008. Of these, 10 declined to participate, 28 were unable to be contacted, and 3 were deceased; therefore, 55 patients were included in the analysis. The mean yearly %EWL to postoperative year 5 was 56% (year 1), 55% (year 2), 46% (year 3), 43% (year 4), and 40% (year 5). Combined improvement and resolution rates at 5 years were 79%, 61%, and 73% for type 2 diabetes, hypertension, and obstructive sleep apnea, respectively. The HbA(1c) was significantly reduced at long-term follow-up. The mean BAROS score was 3.13 (95% CI: 2.4, 3.9). Weight loss outcomes were less favorable in super obese patients.
Weight loss outcomes at 5 year follow-up were modest after SG though improvement in co-morbidity status was maintained.
虽然腹腔镜袖状胃切除术(SG)的早期至中期疗效已得到充分证实,但关于其长期疗效的详细描述相对较少。本研究的目的是评估在作者所在机构接受SG手术患者的长期结局。
所有在过去5年或更长时间内接受SG手术的患者均符合条件。结局指标包括基线人口统计学数据、术前特征、超重减轻百分比(%EWL)、合并症改善和缓解情况、糖化血红蛋白(HbA1c)、血脂谱以及肥胖症分析报告结局系统(BAROS)问卷。还对分层为超级肥胖(体重指数≥50kg/m²)的患者进行了亚组分析。
2007年3月至2008年7月期间有96例患者接受了手术。其中,10例拒绝参与,28例无法联系到,3例死亡;因此,55例患者纳入分析。术后第5年的平均年%EWL分别为第1年56%、第2年55%、第3年46%、第4年43%和第5年40%。2型糖尿病、高血压和阻塞性睡眠呼吸暂停在5年时的综合改善和缓解率分别为79%、61%和73%。长期随访时HbA1c显著降低。平均BAROS评分为3.13(95%CI:2.4,3.9)。超级肥胖患者的减重结局较差。
SG术后5年随访时的减重结局一般,但合并症状态持续改善。