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腹腔镜袖状胃切除术与腹腔镜迷你胃旁路术:一年期结果。

Laparoscopic sleeve gastrectomy versus laparoscopic mini gastric bypass: One year outcomes.

机构信息

Department of General, Digestive and Metabolic Surgery, La Cavale Blanche University Hospital, Boulevard Tanguy Prigent, 29200 Brest, France.

Department of General Surgery, Yves Le Foll Hospital, 10, Rue Marcel Proust 22027 Saint-Brieuc, France.

出版信息

Int J Surg. 2016 Sep;33 Pt A:18-22. doi: 10.1016/j.ijsu.2016.07.051. Epub 2016 Jul 22.

Abstract

PURPOSE

Sleeve gastrectomy (LSG) and mini gastric bypass (LMGB) was considered as emerging procedures but are now considered for many authors as an alternative of the Roux-Y gastric bypass because of similar percentages of weight loss and better postoperative morbidity profiles. However, studies comparing LSG and LMGB are scarce.

MATERIALS AND METHODS

From January 2010 to July 2014, 262 and 161 patients underwent LSG or LMGB in two centre of bariatric surgery, respectively. At one year, rate of follow-up was 88.4%. Main outcome was % of Total Weight Loss (%TWL) at one year. Propensity score matching and multivariable analyses were used to compensate for differences in some baseline characteristics.

RESULTS

After matching LSG (N = 136) and LMGB (N = 136) groups did not differ for initial BMI (kg/m(2)) (43.4 ± 6.5 vs. 42.8 ± 5.0; P = 0.34), % of female patients (91.9% vs. 93.4%; P = 0.64), age (years) (41.2 ± 12.3 vs. 41.2 ± 11.3; P = 0.99) and diabetes (15.4% vs. 19.9%; P = 0.34). At one year, %TWL, change in BMI and rate of stenosis were higher for LMGB group, respectively: 38.2 ± 8.4 vs. 34.3 ± 8.4 (P < 0.0001); -16.5 ± 4.6 vs. -14.9 ± 4.4 (P = 0.005) and 16.9% vs. 0% (P < 0.0001). In multivariate analyses (β coefficient), LMGB was a positive independent factor of %TWL (2.8; P = 0.008).

CONCLUSION

LMGB seems to have better weight loss at one year compared to LSG with higher gastric complications. Further long term studies are needed.

摘要

目的

袖状胃切除术(LSG)和迷你胃旁路术(LMGB)被认为是新兴手术,但现在许多作者认为它们是 Roux-Y 胃旁路术的替代方法,因为它们具有相似的减重百分比和更好的术后发病率。然而,比较 LSG 和 LMGB 的研究很少。

材料和方法

2010 年 1 月至 2014 年 7 月,两个减重手术中心分别有 262 例和 161 例患者接受 LSG 或 LMGB 治疗。一年时,随访率为 88.4%。主要结果是一年时的总体重减轻百分比(%TWL)。采用倾向评分匹配和多变量分析来补偿一些基线特征的差异。

结果

LSG(N=136)和 LMGB(N=136)两组在初始 BMI(kg/m2)(43.4±6.5 vs. 42.8±5.0;P=0.34)、女性患者比例(91.9% vs. 93.4%;P=0.64)、年龄(岁)(41.2±12.3 vs. 41.2±11.3;P=0.99)和糖尿病(15.4% vs. 19.9%;P=0.34)方面无差异。一年时,LMGB 组的%TWL、BMI 变化和狭窄率较高,分别为:38.2±8.4 vs. 34.3±8.4(P<0.0001);-16.5±4.6 vs. -14.9±4.4(P=0.005)和 16.9% vs. 0%(P<0.0001)。多变量分析(β系数)显示,LMGB 是%TWL 的独立正相关因素(2.8;P=0.008)。

结论

与 LSG 相比,LMGB 在一年时似乎具有更好的减重效果,但胃并发症更高。需要进一步的长期研究。

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