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肥胖韩国患者的腹腔镜Roux-en-Y胃旁路手术:疗效及潜在不良事件

Laparoscopic Roux-en-Y gastric bypass in obese Korean patients: efficacy and potential adverse events.

作者信息

Park Ji Yeon, Kim Yong Jin

机构信息

Department of Surgery, Soonchunhyang University Seoul Hospital, 59 Daesagwan-ro, Yongsan-gu, Seoul, 140-743, Republic of Korea.

出版信息

Surg Today. 2016 Mar;46(3):348-55. doi: 10.1007/s00595-015-1170-y. Epub 2015 Apr 26.

DOI:10.1007/s00595-015-1170-y
PMID:25913478
Abstract

PURPOSE

This study aimed to evaluate the medium-term efficacy and adverse events of laparoscopic Roux-en-Y gastric bypass (LRYGB) performed at a single center in Korea.

METHODS

The records of 412 consecutive patients who underwent LRYGB between January 2011 and February 2014 were retrospectively reviewed. The preoperative demographics, surgical outcomes, and follow-up data including anthropometrics indices and late complications were analyzed.

RESULTS

The mean preoperative body mass index was 38.0 ± 5.8 kg/m(2) and 338 patients (82.0 %) had at least one obesity-related comorbidity. Seven patients (1.7 %) developed severe complications requiring invasive intervention or reoperation. The %EWL of the eligible patients was 63.1, 74.3, 79.2, 65.4, and 89.8 % at 6, 12, 18, 24, and 36 months, respectively. Diabetes was resolved in 63.5 % of the followed up patients. Twenty-two out of 256 patients (8.6 %) with available follow-up data failed to achieve  %EWL ≥50 % by 12 months after the surgery. The most frequent late complications were marginal ulcers (24.5 %) and anemia (18.0 %).

CONCLUSION

LRYGB achieves excellent weight loss and significant short- to medium-term comorbidity resolution in Korean obese patients with acceptable perioperative risks. However, late complications including marginal ulcers and nutritional deficiencies are not negligible. Therefore, regular and lifelong surveillance is mandatory in patients undergoing LRYGB.

摘要

目的

本研究旨在评估在韩国单一中心进行的腹腔镜Roux-en-Y胃旁路术(LRYGB)的中期疗效和不良事件。

方法

回顾性分析2011年1月至2014年2月期间连续412例行LRYGB手术患者的记录。分析术前人口统计学资料、手术结果以及包括人体测量指标和晚期并发症在内的随访数据。

结果

术前平均体重指数为38.0±5.8kg/m²,338例患者(82.0%)至少有一种与肥胖相关的合并症。7例患者(1.7%)发生严重并发症,需要进行侵入性干预或再次手术。符合条件患者在6、12、18、24和36个月时的%EWL分别为63.1%、74.3%、79.2%、65.4%和89.8%。63.5%的随访患者糖尿病得到缓解。在256例有可用随访数据的患者中,22例(8.6%)在术后12个月时未能达到%EWL≥50%。最常见的晚期并发症是边缘性溃疡(24.5%)和贫血(18.0%)。

结论

LRYGB在围手术期风险可接受的韩国肥胖患者中实现了显著的体重减轻和明显的短期至中期合并症缓解。然而,包括边缘性溃疡和营养缺乏在内的晚期并发症不容忽视。因此,对接受LRYGB手术的患者进行定期和终身监测是必要的。

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