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腹腔镜袖状胃切除术:长期减重效果

Laparoscopic sleeve gastrectomy: long-term weight loss outcomes.

作者信息

Hirth Douglas A, Jones Edward L, Rothchild Kevin B, Mitchell Breana C, Schoen Jonathan A

机构信息

Department of Surgery, Anschutz Medical Campus of University of Colorado, Aurora, Colorado.

Department of Surgery, Anschutz Medical Campus of University of Colorado, Aurora, Colorado.

出版信息

Surg Obes Relat Dis. 2015 Sep-Oct;11(5):1004-7. doi: 10.1016/j.soard.2015.02.016. Epub 2015 Feb 24.

Abstract

BACKGROUND

Laparoscopic sleeve gastrectomy (LSG) has become an increasingly popular stand-alone weight loss surgery, but there is a paucity of long-term efficacy data.

OBJECTIVE

To determine long-term outcomes for patients undergoing LSG.

SETTING

Tertiary care university hospital in the United States.

METHODS

This study presents a case series of the first 16 patients undergoing LSG at our institution. Inclusion criteria were accepted indications for bariatric surgery, and exclusion criteria were any prior bariatric surgery, gastrectomy, substance abuse, uncontrolled psychiatric illness, end-stage organ disease, or advanced-stage cancer. Patients were followed for 7 years. Outcomes included percent excess weight loss (%EWL), percent weight loss (%WL), resolution of co-morbidities, and major and minor complications.

RESULTS

Patients enrolled in this study had a mean body mass index (BMI) of 43.5 kg/m(2) and a mean age of 49, and 14 of 16 patients were women. Fourteen of 16 patients had 7-year follow-ups with a mean %WL of 29.6%±8.95 and a mean %EWL of 59.6%±89.9%. At 7 years, 11 of 14 patients achieved>50% EWL. One-year follow-up data revealed a mean EWL of 72%±20%, which was significantly greater than the %EWL at 7 years (P = .005). Complications included 1 partial obstruction at the gastric incisura angularis and 1 subacute leak; both were managed endoscopically. There were no reoperations and no deaths. Five of 14 patients experienced new-onset gastroesophageal reflux disease.

CONCLUSIONS

At 7 years postoperative, the LSG remained a durable and successful operation.

摘要

背景

腹腔镜袖状胃切除术(LSG)已成为一种越来越受欢迎的独立减肥手术,但长期疗效数据匮乏。

目的

确定接受LSG手术患者的长期预后。

地点

美国的三级医疗大学医院。

方法

本研究呈现了在我们机构接受LSG手术的首批16例患者的病例系列。纳入标准为符合肥胖症手术的公认指征,排除标准为既往有任何肥胖症手术、胃切除术、药物滥用、未控制的精神疾病、终末期器官疾病或晚期癌症。对患者进行了7年的随访。结局指标包括超重减轻百分比(%EWL)、体重减轻百分比(%WL)、合并症的缓解情况以及主要和次要并发症。

结果

本研究纳入的患者平均体重指数(BMI)为43.5kg/m²,平均年龄为49岁,16例患者中有14例为女性。16例患者中有14例进行了7年随访,平均%WL为29.6%±8.95,平均%EWL为59.6%±89.9%。在7年时,14例患者中有11例实现了>50%的EWL。1年随访数据显示平均EWL为72%±20%,显著高于7年时的%EWL(P = 0.005)。并发症包括1例胃角切迹处部分梗阻和1例亚急性渗漏;均通过内镜处理。无再次手术,无死亡病例。14例患者中有5例出现新发胃食管反流病。

结论

术后7年,LSG仍是一种持久且成功的手术。

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