Hoyuela Carlos
Carlos Hoyuela, Department of General and Digestive Surgery, Hospital Plató, Universitat Autònoma de Barcelona, 08006 Barcelona, Spain.
World J Gastrointest Surg. 2017 Apr 27;9(4):109-117. doi: 10.4240/wjgs.v9.i4.109.
To prospectively evaluate the postoperative morbi-mortality and weight loss evolution of patients who underwent a laparoscopic sleeve gastrectomy (LSG) as a primary bariatric procedure during 5 years of follow-up.
Since 2006, data from patients undergoing a highly restrictive primary LSG have been prospectively registered in a database and analysed. Preoperative co-morbid conditions, operating time, hospital stay, early and late complications rate and evolution of weight loss after 5 years of follow-up were analysed.
A total of 156 patients were included, 74.3% of whom were women. The mean age was 43.2 ± 13.1 years and the mean body mass index (BMI) was 41.5 ± 7.9 kg/m. Seventy patients (44.8%) presented a BMI under 40 kg/m. The mortality rate was 0%. The leakage rate was 1.2%, and the total 30-d morbidity rate was 5.1% (8/156). With a mean follow-up of 32.7 ± 28.5 (range 6-112) mo, the mean percent of excess of weight loss (%EWL) was 82.0 ± 18.8 at 1 year, 76.7 ± 21.3 at 3 years and 60.3 ± 28.9 at 5 years. The mean percent of excess of BMI loss (%EBMIL) was 94.9 ± 22.4 at 1 year, 89.4 ± 27.4 at 3 years and 74.8 ± 29.4 at 5 years. Patients with preoperative BMI less than 40 kg/m achieved greater weight loss than did the overall study population. Diabetes remitted in 75% of the patients and HTA improved in 71.7%. CPAP masks were withdrawn in all patients with obstructive sleep apnoea.
LSG built with a narrow 34 F bougie and starting 3 cm from the pylorus proved to be safe and highly effective in terms of weight loss as a stand-alone procedure, particularly in patients with a preoperative BMI lower than 40 kg/m.
前瞻性评估接受腹腔镜袖状胃切除术（LSG）作为主要减肥手术的患者在5年随访期内的术后发病率、死亡率及体重减轻情况。
自2006年起，对接受高度限制性原发性LSG的患者数据进行前瞻性登记并分析。分析术前合并症、手术时间、住院时间、早期和晚期并发症发生率以及5年随访后的体重减轻情况。
共纳入156例患者，其中74.3%为女性。平均年龄为43.2±13.1岁，平均体重指数（BMI）为41.5±7.9kg/m²。70例（44.8%）患者的BMI低于40kg/m²。死亡率为0%。渗漏率为1.2%，30天总发病率为5.1%（8/156）。平均随访32.7±28.5（范围6 - 112）个月，1年时平均超重体重减轻百分比（%EWL）为82.0±18.8，3年时为76.7±21.3，5年时为60.3±28.9。平均超重BMI降低百分比（%EBMIL）1年时为94.9±22.4，3年时为89.4±27.4，5年时为74.8±29.4。术前BMI低于40kg/m²的患者比总体研究人群减重更多。75%的患者糖尿病缓解，71.7%的患者高血压改善。所有阻塞性睡眠呼吸暂停患者均停用了持续气道正压通气（CPAP）面罩。
使用34F窄探条并从幽门起始3cm构建的LSG作为独立手术在减肥方面被证明是安全且高效的，尤其对于术前BMI低于40kg/m²的患者。
