Melissas John, Stavroulakis Konstantinos, Tzikoulis Vassilis, Peristeri Angeliki, Papadakis John A, Pazouki Abdolreza, Khalaj Alireza, Kabir Ali
Bariatric Unit, Heraklion University Hospital, 164 Erythreas str, 71409, Heraklion, Greece.
Department of Internal Medicine, Heraklion University Hospital, Heraklion, Crete, Greece.
Obes Surg. 2017 Apr;27(4):847-855. doi: 10.1007/s11695-016-2395-6.
The purpose of this study is to compare sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGBP) performed in Institutions participating in IFSO-European Chapter, Center of Excellence (COE) program.
Since the initiation of the program in January 2010, 6413 SGs and 10,622 RYGBPs performed as primary procedures by December 31, 2014, with at least 12-month follow-up, were retrospectively compared.
There were steadily increasing numbers of patients underwent SG from 2010 to 2015. Early (<30 days) postoperative complication rate of 3.02 % for RYGBP was significantly higher than 2.12 % seen after SG (p = 0.0006). Only two patients, one in each group, died in the first 30 postoperative days (0.016 % mortality for SG vs 0.009 % for RYGBP-NS). From SG group, 103 patients, 1.61 %, and 206 patients, 1.94 %, from RYGBP group required readmission following hospital discharge in the first 30 days following bariatric surgery-NS. From the readmitted patients in the SG group, 75.72 % were reoperated vs 50.50 % in the RYGBP group (p < 0.0001). SG patients were heavier (BMI 44.93 vs 43.96 kg/m, p < 0.0001). However, significantly better % excess weight loss were seen following RYGBP in all postoperative years (60.36 vs 67.72 %, p = 0.002 at fifth year). Better remission rates were seen for diabetes, arterial hypertension, dyslipidemia, and sleep apnea syndrome after RYGBP in the first postoperative year.
Both procedures were performed with very low complications, mortality, readmissions, and reoperations rate. Better weight loss was observed following RYGBP, the first five postoperative years.
本研究旨在比较国际肥胖与代谢病外科联盟(IFSO)欧洲分会卓越中心(COE)项目参与机构所实施的袖状胃切除术(SG)和 Roux-en-Y 胃旁路术(RYGBP)。
自 2010 年 1 月该项目启动至 2014 年 12 月 31 日,对 6413 例 SG 手术和 10622 例 RYGBP 手术作为初次手术且至少随访 12 个月的病例进行回顾性比较。
2010 年至 2015 年接受 SG 手术的患者数量稳步增加。RYGBP 术后早期(<30 天)并发症发生率为 3.02%,显著高于 SG 术后的 2.12%(p = 0.0006)。术后 30 天内每组仅 1 例患者死亡(SG 死亡率为 0.016%,RYGBP 为 0.009%,无统计学差异)。SG 组 1.61%(103 例)患者和 RYGBP 组 1.94%(206 例)患者在减重手术后的前 30 天出院后需要再次入院(无统计学差异)。在再次入院的患者中,SG 组 75.72%接受了再次手术,而 RYGBP 组为 50.50%(p < 0.0001)。SG 组患者体重更重(BMI 为 44.93 对 43.96kg/m²,p < 0.0001)。然而,在所有术后年份中,RYGBP 术后的超重减轻百分比显著更高(第五年时分别为 60.36%对 67.72%,p = 0.002)。RYGBP 术后第一年糖尿病、动脉高血压、血脂异常和睡眠呼吸暂停综合征的缓解率更高。
两种手术的并发症、死亡率、再次入院率和再次手术率均非常低。在术后的前五年,RYGBP 的减重效果更佳。