Park Yeon Ho, Kim Seong Min
Department of Surgery, Gil Medical Center, Gachon University of Medicine and Science, Incheon, Korea.
Yonsei Med J. 2017 Sep;58(5):1025-1030. doi: 10.3349/ymj.2017.58.5.1025.
The aim of this study was the compare the midterm outcomes of laparoscopic greater curvature plication (LGCP) and laparoscopic sleeve gastrectomy (LSG) in obese patients with a body mass index (BMI) of 30 to 35 kg/m².
This single center, retrospective review of prospectively collected data was conducted for obese patients that underwent LGCP or LSG from March 2013 to February 2016. These two patient groups were compared in terms of demographics, perioperative outcomes, weight loss [percent excess weight loss (%EWL)], comorbidity resolution, and immediate and long-term complications.
A total of 149 patients were eligible for the study. Seventy-five patients underwent LGCP (group A) and 74 LSG (group B). These two groups were matched for age, gender, and baseline BMI. Three patients in each group were readmitted for complications within 30 days postoperatively. %EWL in groups A and B were 51.1±16.9 and 47.8±20.8 at 3 months (p=0.084), 71.1±20.2 and 74.5±21.8 at 6 months (p=0.165), 77.1±18.4 and 87.8±25.1 at 12 months (p=0.002), 70.5±18.5 and 83.4±28.7 at 24 months (p=0.005), and 67.3±15.3 and 78.6±31.7 at 36 months (p=0.054), respectively. Intergroup differences in resolution rates of metabolic comorbidities between the two groups were not significant.
Although mean weight loss after LGCP was inferior to that after LSG, especially after six months postoperatively, it was acceptable, and LGCP had an excellent metabolic comorbidity resolution rate in patients with BMIs, ranging from 30 to 35 kg/m².
本研究旨在比较体重指数(BMI)为30至35kg/m²的肥胖患者行腹腔镜大弯折叠术(LGCP)和腹腔镜袖状胃切除术(LSG)的中期疗效。
对2013年3月至2016年2月期间接受LGCP或LSG的肥胖患者进行单中心、回顾性研究,该研究回顾了前瞻性收集的数据。比较这两组患者的人口统计学特征、围手术期结局、体重减轻情况[超重体重减轻百分比(%EWL)]、合并症缓解情况以及近期和远期并发症。
共有149例患者符合研究条件。75例行LGCP(A组),74例行LSG(B组)。两组在年龄、性别和基线BMI方面相匹配。每组各有3例患者在术后30天内因并发症再次入院。A组和B组在术后3个月时的%EWL分别为51.1±16.9和47.8±20.8(p=0.084),6个月时分别为71.1±20.2和74.5±21.8(p=0.165),12个月时分别为77.1±18.4和87.8±25.1(p=0.002),24个月时分别为70.5±18.5和83.4±28.7(p=0.005),36个月时分别为67.3±15.3和78.6±31.7(p=0.054)。两组间代谢合并症缓解率的组间差异无统计学意义。
尽管LGCP术后的平均体重减轻低于LSG术后,尤其是术后6个月后,但仍可接受,且LGCP在BMI为30至35kg/m²的患者中具有良好的代谢合并症缓解率。