Madhok B M, Mahawar K K, Hadfield J N, Courtney M, Stubbing-Moore A, Koshy S, Small P K
Bariatric Unit, Department of General Surgery, Sunderland Royal Hospital, City Hospitals Sunderland NHS Foundation Trust, Sunderland, UK.
Clin Obes. 2018 Feb;8(1):43-49. doi: 10.1111/cob.12227. Epub 2017 Oct 23.
Many surgeons believe mini gastric bypass (MGB) is more likely to cause micronutrient malabsorption compared to Roux-en-Y gastric bypass (RYGB). Till date, there is no published study evaluating haematological indices and haematinic levels in patients undergoing MGB and comparing these with a matched cohort of RYGB. Two hundred patients who underwent MGB between October 2012 and October 2015 were matched to 200 patients who underwent RYGB for age, sex, body mass index and time of surgery. We then compared haemoglobin, mean corpuscular volume, iron, ferritin, vitamin B12 and folic acid levels preoperatively and at 6 monthly intervals after surgery until 2 years. The percentage total weight loss was significantly higher in the MGB group compared to the RYGB group at all time points. At 2 years, MGB and RYGB both led to an increase in anaemia rates but the difference was only significant for MGB group. Compared to RYGB, MGB patients were more likely to be anaemic at 2 years, although the difference was not significant statistically (16.6% vs. 12.7%; P value = 0.55). There was a trend for lower iron and folate levels in MGB group compared to RYGB group but the difference was statistically significant at some of the time periods only (significantly lower folate at 6 and 12 months and lower iron at 6 months in the MGB group). MGB leads to a significant increase in anaemia rates in a supplemented cohort. There is a trend towards lower iron and folate levels and higher anaemia rates in MGB group in comparison with RYGB. Larger studies with longer follow-up should evaluate results of MGB with a shorter biliopancreatic limb.
许多外科医生认为，与 Roux-en-Y 胃旁路术（RYGB）相比，迷你胃旁路术（MGB）更易导致微量营养素吸收不良。迄今为止，尚无已发表的研究评估接受 MGB 的患者的血液学指标和造血素水平，并将其与匹配的 RYGB 队列进行比较。将 2012 年 10 月至 2015 年 10 月期间接受 MGB 的 200 名患者，按照年龄、性别、体重指数和手术时间与 200 名接受 RYGB 的患者进行匹配。然后我们比较了术前以及术后每 6 个月直至 2 年时的血红蛋白、平均红细胞体积、铁、铁蛋白、维生素 B12 和叶酸水平。在所有时间点，MGB 组的总体重减轻百分比均显著高于 RYGB 组。在 2 年时，MGB 和 RYGB 均导致贫血率增加，但差异仅在 MGB 组显著。与 RYGB 相比，MGB 患者在 2 年时更易贫血，尽管差异无统计学意义（16.6% 对 12.7%；P 值 = 0.55）。与 RYGB 组相比，MGB 组的铁和叶酸水平有降低趋势，但仅在某些时间段差异有统计学意义（MGB 组在 6 个月和 12 个月时叶酸显著降低，在 6 个月时铁降低）。在补充队列中，MGB 导致贫血率显著增加。与 RYGB 相比，MGB 组有铁和叶酸水平降低以及贫血率升高的趋势。需要进行更大规模、更长随访时间的研究来评估采用较短胆胰支的 MGB 的结果。
