Moloney B M, Hynes D A, Kelly M E, Iqbal A, O'Connor E, Lowe D, McAnena O J
Department of Surgery, Galway University Hospital, Saolta University Healthcare Group, Galway, Ireland.
Galway Clinic, Galway, Ireland.
Ir J Med Sci. 2017 Feb;186(1):143-149. doi: 10.1007/s11845-016-1484-9. Epub 2016 Jul 28.
Global prevalence of obesity has soared. Where lifestyle and medical treatments have failed, laparoscopic sleeve gastrectomy (LSG) is increasingly regarded as a good surgical procedure for morbid obesity. Following the introduction of LSG, we assessed our surgical outcomes.
We reviewed a consecutive series of LSGs from January 2009 to January 2015. Our primary focus was to assess the success of this procedure on the percentage excess body weight loss (%EWL), Body Mass Index (BMI), hypertension and diabetes. Additionally, we evaluated the rate of procedure-related complications.
There were 183 consecutive patients evaluated. Median age was 45 years (24-73). The majority were female (73.2 %, n = 134). At 1 year post-op, median %EWL was 57.6 %. There was an associated median reduction in BMI of 16 kg/m (0-33). At 2 years, median %EWL was sustained at 58.4 %. The median reduction in BMI was 16 kg/m (4-32). At 2-year post-op, 78.9 % of diabetic patients had their diabetic medications completely discontinued, while a further 15.8 % having their medication reduced. 34.6 % of hypertensive patients had their antihypertensives discontinued, with 50 % having medications reduced. There was no procedure related mortality. 3.3 % (n = 6) of patients had a confirmed staple-line leak.
This study shows LSG is a safe and successful management strategy for morbid obesity. In addition to the direct effects of sustained weight loss, it highlights indirect effects that LSG has on obesity-related health issues, with substantial reduction in diabetic and anti-hypertensive medications. Our results reaffirm international studies of the beneficial effects of LSG on Type II diabetes and hypertension.
全球肥胖患病率飙升。在生活方式干预和药物治疗无效的情况下，腹腔镜袖状胃切除术（LSG）越来越被视为治疗病态肥胖的一种良好手术方法。在引入LSG后，我们评估了我们的手术效果。
我们回顾了2009年1月至2015年1月连续进行的一系列LSG手术。我们的主要重点是评估该手术在超重体重减轻百分比（%EWL）、体重指数（BMI）、高血压和糖尿病方面的成功率。此外，我们评估了手术相关并发症的发生率。
连续评估了183例患者。中位年龄为45岁（24 - 73岁）。大多数为女性（73.2%，n = 134）。术后1年，中位%EWL为57.6%。BMI中位数相应降低了16 kg/m²（0 - 33）。2年时，中位%EWL维持在58.4%。BMI中位数降低了16 kg/m²（4 - 32）。术后2年，78.9%的糖尿病患者完全停用了糖尿病药物，另有15.8%的患者减少了用药。34.6%的高血压患者停用了抗高血压药物，50%的患者减少了用药。无手术相关死亡。3.3%（n = 6）的患者确诊为吻合口漏。
本研究表明LSG是治疗病态肥胖的一种安全且成功的管理策略。除了持续减重的直接效果外，它还突出了LSG对肥胖相关健康问题的间接影响，糖尿病和抗高血压药物用量大幅减少。我们的结果再次证实了国际上关于LSG对2型糖尿病和高血压有益作用的研究。
