Park Ji Yeon, Kim Yong Jin
Department of Surgery, Soonchunhyang University Seoul Hospital, Seoul, Korea.
Ann Surg Treat Res. 2015 May;88(5):246-52. doi: 10.4174/astr.2015.88.5.246. Epub 2015 Apr 30.
Laparoscopic sleeve gastrectomy (LSG) has been gaining marked popularity as a stand-alone treatment for morbid obesity. This study aimed to evaluate the midterm outcomes and efficacy of LSG performed at a single center in Korea.
The records of 192 consecutive patients who underwent LSG between April 2009 and December 2012 were retrospectively reviewed. The patients' demographics and surgical outcomes including anthropometric data were analyzed.
The mean preoperative body mass index was 40.0 ± 7.2 kg/m(2), and 120 patients (62.5%) had at least one obesity-related comorbidity. Three patients (1.6%) required endoscopic or surgical intervention to manage postoperative bleeding or leakage. At the postoperative 1-, 2-, 3-, and 4-year follow-ups, the mean percent of excess weight loss (%EWL) values were 72.6%, 80.6%, 71.1%, and 57.8%, respectively, with follow-up rates of 81%, 56%, 58%, and 30% respectively. The overall mean %EWL reached 68.3% ± 27.2% at a mean follow-up of 25 months. Obesity-related comorbidities were resolved in >70% of the patients after surgery. Twelve months after LSG, 25 patients (13.0%) showed a %EWL of <50%; 9 (4.7%) required conversion to gastric bypass due to inadequate weight loss, intolerable reflux symptoms, or intractable diabetes.
These midterm results show that LSG is a safe and effective surgical procedure for morbidly obese patients. However, a longer follow-up period is necessary to elucidate whether LSG can achieve durable weight loss and long-term outcomes, comparable to those of more aggressive procedures.
腹腔镜袖状胃切除术(LSG)作为一种治疗病态肥胖的独立手术方法,已越来越受到广泛欢迎。本研究旨在评估在韩国单一中心进行的LSG的中期疗效。
回顾性分析了2009年4月至2012年12月期间连续接受LSG的192例患者的病历。分析了患者的人口统计学数据和包括人体测量数据在内的手术结果。
术前平均体重指数为40.0±7.2kg/m²,120例患者(62.5%)至少有一种与肥胖相关的合并症。3例患者(1.6%)需要内镜或手术干预来处理术后出血或渗漏。在术后1年、2年、3年和4年的随访中,平均超重体重减轻百分比(%EWL)值分别为72.6%、80.6%、71.1%和57.8%,随访率分别为81%、56%、58%和30%。平均随访25个月时,总体平均%EWL达到68.3%±27.2%。超过70%的患者术后与肥胖相关的合并症得到缓解。LSG术后12个月,25例患者(13.0%)的%EWL<50%;9例患者(4.7%)因体重减轻不足、无法忍受的反流症状或难治性糖尿病而需要转为胃旁路手术。
这些中期结果表明,LSG对于病态肥胖患者是一种安全有效的手术方法。然而,需要更长的随访期来阐明LSG是否能实现持久的体重减轻和长期疗效,与更激进的手术方法相当。