Hospital DIPRECA, Santiago, Chile; Universidad Diego Portales, Santiago, Chile.
Hospital El Carmen, Santiago, Chile.
Surg Obes Relat Dis. 2017 Oct;13(10):1676-1681. doi: 10.1016/j.soard.2017.07.017. Epub 2017 Jul 25.
Laparoscopic sleeve gastrectomy (LSG) has become an option as a bariatric surgical technique. There is a lack of long-term results of this procedure in the literature. The aim of this study is to present weight loss results of LSG for up to 7 years of follow-up.
A retrospective series of patients who underwent LSG between 2008 and 2011 was examined. The primary endpoint was weight loss: percentage of excess weight loss (%EWL), percentage of total weight loss (%TWL), and body mass index (BMI) were reported. Failure was defined as %EWL<50%. Multivariate analysis for weight loss was performed. The complications rate was reported.
A total of 148 patients met the inclusion criteria; 76.3% were female. Mean preoperative BMI was 36 ± 4 kg/m. Mean operative time was 89.3 ± 3.2 minutes. Follow-up at 5, 6, and 7 years was 77.7%, 83.3%, and 82.2%, respectively. Mean %EWL and %TWL at 1, 3, 5, and 7 years was 93.2%, 80.7%, 70.6%, and 51.7%, and 27.2%, 23.3%, 20.4%, and 16.3%, respectively. The failure rate was 30.4% at the fifth year and 51.4% at the seventh year. High preoperative BMI was related to worse %EWL (P<0.001) but not to %TWL. Preoperative BMI<35 kg/m was associated with better %EWL but not with %TWL (P = 0.003). Four leaks (2.7%) and no mortalities were reported.
LSG is an acceptable surgical technique for weight loss, but in this series, up to one third of the patients fail at the fifth year and half fail in the seventh year. %EWL is better in patients with BMI<35 kg/m, but this difference disappears when we express outcomes with %TWL.
腹腔镜袖状胃切除术（LSG）已成为一种减重手术选择。该手术的长期结果在文献中较为缺乏。本研究旨在展示 LSG 术后长达 7 年的随访减重结果。
回顾性分析了 2008 年至 2011 年间接受 LSG 的患者系列。主要终点是体重减轻：体重减轻百分比（%EWL）、总体重减轻百分比（%TWL）和体重指数（BMI）。将减重效果<50%定义为失败。对减重的多变量分析进行了。报告并发症发生率。
共纳入 148 例患者；76.3%为女性。术前平均 BMI 为 36±4kg/m。平均手术时间为 89.3±3.2 分钟。5、6 和 7 年的随访率分别为 77.7%、83.3%和 82.2%。1、3、5 和 7 年的平均%EWL 和%TWL 分别为 93.2%、80.7%、70.6%和 51.7%和 27.2%、23.3%、20.4%和 16.3%。第 5 年和第 7 年的失败率分别为 30.4%和 51.4%。术前高 BMI 与减重效果差有关（P<0.001），但与 %TWL 无关。术前 BMI<35kg/m 与更好的%EWL 相关，但与%TWL 无关（P=0.003）。报告了 4 例漏（2.7%）和无死亡。
LSG 是一种可接受的减重手术技术，但在本系列中，多达三分之一的患者在第 5 年失败，一半在第 7 年失败。BMI<35kg/m 的患者%EWL 更好，但当我们用%TWL 表示结果时，这种差异就消失了。
