Abelson Jonathan S, Afaneh Cheguevera, Dolan Patrick, Chartrand Genevevie, Dakin Gregory, Pomp Alfons
Department of Surgery, Weill Cornell Medical Center, New York-Presbyterian Hospital, Weill Cornell Medical College, 525 East 68th St, Box 294, New York, NY, 10065, USA.
Obes Surg. 2016 Aug;26(8):1788-93. doi: 10.1007/s11695-015-2002-2.
Bariatric surgery is effective at achieving sustained weight loss and improving the control and resolution of obesity-related co-morbidities. Most studies that have demonstrated co-morbidity resolution in patients undergoing laparoscopic sleeve gastrectomy (LSG) only follow patients for the short term (less than 1 year) or follow a relatively small cohort (<100 patients) for the intermediate or long term (more than 5 years). We report our experience following a large cohort of morbidly obese patients who underwent LSG with intermediate-term follow-up.
We retrospectively reviewed 435 consecutive patients who underwent LSG from January 2004 to November 2013. Co-morbidities investigated included diabetes mellitus (DM), hypertension (HTN), and hyperlipidemia (HL). A co-morbidity was determined to be resolved if the patient was no longer taking any medication to treat that specific co-morbidity.
Mean follow-up was 26 ± 25 months (range = 1-112). Mean postoperative total weight loss (%TWL) at 6, 12, 24, 36, 48, 60, and 72 months were 23.6, 29.9, 29.5, 25.2, 26.7, 25.4, and 24.3 %, respectively. The incidence of all three co-morbidities was found to be significantly lower at the last patient follow-up. The resolution rates for DM, HTN, and HL were 59, 31, and 50 %, respectively. In patients who continued to have co-morbidities, the mean numbers of medications for DM (1.2 ± 0.7 vs. 0.5 ± 0.7, p < 0.0001), HTN (1.8 ± 1.1 vs. 1.3 ± 1.2, p < 0.0001), and HL (0.9 ± 0.7 vs. 0.6 ± 0.6, p < 0.0001) postoperatively were all significantly less.
LSG is effective at achieving significant and sustained weight loss, improvement in co-morbidity profiles, and a reduction in poly-pharmacy for these conditions over intermediate-term follow-up.
减肥手术在实现持续体重减轻以及改善肥胖相关合并症的控制和缓解方面是有效的。大多数已证明接受腹腔镜袖状胃切除术（LSG）的患者合并症得到缓解的研究，仅对患者进行短期随访（少于1年），或者对相对较小的队列（<100例患者）进行中期或长期（超过5年）随访。我们报告了一大群接受LSG且进行中期随访的病态肥胖患者的情况。
我们回顾性分析了2004年1月至2013年11月连续接受LSG的435例患者。所调查的合并症包括糖尿病（DM）、高血压（HTN）和高脂血症（HL）。如果患者不再服用任何治疗该特定合并症的药物，则判定该合并症已得到缓解。
平均随访时间为26±25个月（范围为1 - 112个月）。术后6、12、24、36、48、60和72个月的平均术后总体重减轻百分比（%TWL）分别为23.6%、29.9%、29.5%、25.2%、26.7%、25.4%和24.3%。在最后一次患者随访时，发现所有三种合并症的发生率均显著降低。DM、HTN和HL的缓解率分别为59%、31%和50%。在仍有合并症的患者中，术后DM（1.2±0.7对0.5±0.7，p<0.0001）、HTN（1.8±1.1对1.3±1.2，p<0.0001）和HL（0.9±0.7对0.6±0.6，p<0.0001）的平均用药数量均显著减少。
在中期随访中，LSG在实现显著且持续的体重减轻、改善合并症情况以及减少这些病症的联合用药方面是有效的。
