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早期体重减轻作为袖状胃切除术后2年体重减轻及合并症缓解的预测指标。

Early Weight Loss as a Predictor of 2-Year Weight Loss and Resolution of Comorbidities After Sleeve Gastrectomy.

作者信息

Obeidat Firas, Shanti Hiba

机构信息

Department of General Surgery, Faculty of Medicine, The University of Jordan, Amman, Jordan.

Minimally Invasive Gastrointestinal and Bariatric Surgery, Jordan University Hospital, Queen Rania St., P.O. Box 13046, Amman, 11942, Jordan.

出版信息

Obes Surg. 2016 Jun;26(6):1173-7. doi: 10.1007/s11695-015-1903-4.

Abstract

BACKGROUND

The objective of this study was to investigate whether early postoperative weight loss predicts weight loss 1 and 2 years after laparoscopic sleeve gastrectomy (LSG) and to determine its effect on the resolution of comorbidities.

METHODS

This was a prospective study of patients who underwent LSG at Jordan University Hospital from February 2009 to January 2014.

RESULTS

One hundred ninety patients (mean age 34.0 ± 10.8 years; mean preoperative body mass index 46.2 ± 7.7 kg/m(2)) were included in the study. Of these, 146 were followed for 1 year and 73 were followed for 2 years. Thirty patients (20.5 %) had hypertension, 23 (15.8 %) had diabetes, 78 (53.4 %) had hyperlipidemia, 30 (20.5 %) had obstructive sleep apnea, and 50 (34.2 %) had more than one comorbidity. The percentage of excess weight loss (%EWL) was 22.7 ± 8.1, 75.1 ± 22.8, and 72.6 ± 17.5 at 1, 12, and 24 months, respectively. Fifty-five patients (37.7 %) had a 1-year %EWL of ≥80 %, and 29 (39.7 %) had a 2-year %EWL of ≥80 %. Linear regression analysis showed a strong correlation between 1-month %EWL and %EWL at 1 year (r (2) = 0.23, p < 0.001) and 2 years (r (2) = 0.28, p < 0.001). Resolution of comorbidities was associated with higher %EWL achieved at 1 year, but early postoperative weight loss did not have a significant effect on comorbidity resolution.

CONCLUSIONS

Early postoperative weight loss can be used to identify and target poor responders.

摘要

背景

本研究的目的是调查腹腔镜袖状胃切除术(LSG)后早期体重减轻是否可预测术后1年和2年的体重减轻情况,并确定其对合并症缓解的影响。

方法

这是一项对2009年2月至2014年1月在约旦大学医院接受LSG手术患者的前瞻性研究。

结果

190例患者(平均年龄34.0±10.8岁;术前平均体重指数46.2±7.7kg/m²)纳入本研究。其中,146例随访1年,73例随访2年。30例(20.5%)患有高血压,23例(15.8%)患有糖尿病,78例(53.4%)患有高脂血症,30例(20.5%)患有阻塞性睡眠呼吸暂停,50例(34.2%)患有不止一种合并症。术后1个月、12个月和24个月时,超重减轻百分比(%EWL)分别为22.7±8.1、75.1±22.8和72.6±17.5。55例患者(37.7%)术后1年的%EWL≥80%,29例(39.7%)术后2年的%EWL≥80%。线性回归分析显示,术后1个月的%EWL与术后1年(r²=0.23,p<0.001)和2年(r²=0.28,p<0.001)的%EWL之间存在强相关性。合并症的缓解与术后1年达到的较高%EWL相关,但术后早期体重减轻对合并症缓解没有显著影响。

结论

术后早期体重减轻可用于识别和针对反应不佳者。

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