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减肥手术对病态肥胖患者代谢综合征改善的影响:腹腔镜袖状胃切除术与腹腔镜Roux-en-Y胃旁路术的比较

The effects of bariatric surgical procedures on the improvement of metabolic syndrome in morbidly obese patients: Comparison of laparoscopic sleeve gastrectomy versus laparoscopic Roux-en-Y gastric bypass.

作者信息

Kafalı Mehmet Ertuğrul, Şahin Mustafa, Ece İlhan, Acar Fahrettin, Yılmaz Hüseyin, Alptekin Hüsnü, Ateş Leyla

机构信息

Department of General Surgery, Selçuk University School of Medicine, Konya, Turkey.

出版信息

Turk J Surg. 2017 Sep 1;33(3):142-146. doi: 10.5152/turkjsurg.2017.3865. eCollection 2017.

Abstract

OBJECTIVE

The objective of this study was to evaluate patients who underwent laparoscopic Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy in terms of weight loss, metabolic parameters, and postoperative complications.

MATERIAL AND METHODS

Data on patients who underwent laparoscopic Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy with a diagnosis of morbid obesity between January 2012 and June 2014 were retrospectively evaluated. Patients were compared in terms of age, sex, body mass index, duration of operation, American Society of Anesthesiologists score, perioperative complications, length of hospital stay, and long term follow-up results.

RESULTS

During the study period, 91 patients (45 laparoscopic Roux-en-Y gastric bypass and 46 laparoscopic sleeve gastrectomy) underwent bariatric surgery. There was no difference between the two groups in terms of preoperative patient characteristics. Both groups showed statistically significant weight loss and improvement in co-morbidities when compared with the preoperative period. Weight loss and improvement in metabolic parameters were similar in both groups. The duration of operation and hospital stay was longer in the laparoscopic Roux-en-Y gastric bypass group. Furthermore, the rate of total complications was significantly lower in the laparoscopic sleeve gastrectomy group.

CONCLUSION

Laparoscopic sleeve gastrectomy is a safe and effective method with a significantly lower complication rate and length of hospital stay than laparoscopic Roux-en-Y gastric bypass, with similar improvement rates in metabolic syndrome.

摘要

目的

本研究旨在评估接受腹腔镜Roux-en-Y胃旁路术和腹腔镜袖状胃切除术的患者在体重减轻、代谢参数及术后并发症方面的情况。

材料与方法

回顾性评估2012年1月至2014年6月期间诊断为病态肥胖并接受腹腔镜Roux-en-Y胃旁路术和腹腔镜袖状胃切除术的患者数据。对患者的年龄、性别、体重指数、手术时长、美国麻醉医师协会评分、围手术期并发症、住院时间及长期随访结果进行比较。

结果

研究期间,91例患者(45例行腹腔镜Roux-en-Y胃旁路术,46例行腹腔镜袖状胃切除术)接受了减肥手术。两组患者术前特征无差异。与术前相比,两组患者体重均显著减轻,合并症均有所改善。两组患者体重减轻及代谢参数改善情况相似。腹腔镜Roux-en-Y胃旁路术组手术时长和住院时间更长。此外,腹腔镜袖状胃切除术组总并发症发生率显著更低。

结论

腹腔镜袖状胃切除术是一种安全有效的方法,与腹腔镜Roux-en-Y胃旁路术相比,并发症发生率和住院时间显著更低,代谢综合征改善率相似。

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