Kasalický M, Bařinka A, Čierny M, Fried M, Gryga A, Holéczy P, Hrubý M, Malčánková K, Michalský D, Procházka V, Satinský I, Šimonik I, Vraný M, Zonča P
Rozhl Chir. 2016 Winter;95(12):425-431.
Sleeve gastrectomy (SG) as a single bariatric/metabolic procedure has been performed since 2003 in the world, and since 2006 in the Czech Republic. We report 10 years experience with SG in the Czech Republic from 2006 to 2015.
Prospectively collected data from 14 surgical departments was evaluated retrospectively using descriptive statistics for every year from 2006 to 2015 and subsequently evaluated and compared for the entire period. The number of the patients, mean age, mean weight and BMI at the time of surgery, the number of patients with T2DM after SG, mean follow-up, mean %BMIL (% Body Mass Index Loss), distance of the starting point of the resection line from the pylorus, the size of the calibration bougie, the rate of complications, and the number and type of conversion procedures were evaluated.
4134 sleeve gastrectomies were done in the Czech Republic from 2006 to 2015 with the mean follow-up of 32.9 months (range 2145 months) from the procedure. The mean weight at the time of surgery fluctuated between 114.2 kg and 128.9 kg; mean BMI fluctuated between 42.3 and 46.7. Mean %BMIL was 63.2% for the entire evaluated period. The distance of the starting point of the resection line from the pylorus changed from the mean 6.1 cm (range 67 cm) to mean 4.2 cm (range 36 cm) and the size of the calibration bougie changed from the mean 39.2 F (range 3642 F) to mean 37.1 F (range 3542 F). As regards early postoperative complications, bleeding from the resection line occurred in 1.4% and a leak from the staple line occurred in 1.1%. The gastroesophageal reflux disease and hiatal hernia occurred in 17.3% as the most frequent late complications. Conversion to another bariatric procedure was approached in 3.8% in the event of an unsatisfactory effect of the SG.
Bariatric or metabolic surgery, respectively, is a safe and effective surgical method for the treatment of severe obesity and T2DM in morbidly obese patients. Currently, SG is the most widely used bariatric/metabolic procedure in the Czech Republic as well as in most other countries and the long-time results are similar in comparison with other authors.Key words: bariatric surgery - sleeve gastrectomy - resection line - complications.
自2003年起，袖状胃切除术（SG）作为一种单一的减肥/代谢手术在全球开展，自2006年起在捷克共和国开展。我们报告了2006年至2015年在捷克共和国开展SG的10年经验。
回顾性评估前瞻性收集的来自14个外科科室的数据，对2006年至2015年每年的数据进行描述性统计，随后对整个时期的数据进行评估和比较。评估了患者数量、手术时的平均年龄、平均体重和体重指数（BMI）、SG术后2型糖尿病患者数量、平均随访时间、平均体重指数降低百分比（%BMIL）、切除线起点与幽门的距离、校准探条尺寸、并发症发生率以及转换手术的数量和类型。
2006年至2015年在捷克共和国共进行了4134例袖状胃切除术，术后平均随访32.9个月（范围2 - 145个月）。手术时的平均体重在114.2千克至128.9千克之间波动；平均BMI在42.3至46.7之间波动。整个评估期间的平均%BMIL为63.2%。切除线起点与幽门的距离从平均6.1厘米（范围6 - 7厘米）变为平均4.2厘米（范围3 - 6厘米），校准探条尺寸从平均39.2F（范围36 - 42F）变为平均37.1F（范围35 - 42F）。术后早期并发症方面，切除线出血发生率为1.4%，吻合钉线漏发生率为1.1%。胃食管反流病和食管裂孔疝作为最常见的晚期并发症发生率为17.3%。若SG效果不理想，3.8%的患者转换为其他减肥手术。
减肥或代谢手术分别是治疗病态肥胖患者严重肥胖和2型糖尿病的一种安全有效的手术方法。目前，SG是捷克共和国以及大多数其他国家使用最广泛的减肥/代谢手术，与其他作者的研究相比，长期结果相似。关键词：减肥手术 - 袖状胃切除术 - 切除线 - 并发症
