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腹腔镜Roux-en-Y胃旁路术(LRYGB)和腹腔镜袖状胃切除术(LSG)治疗病态肥胖后手术和内镜治疗晚期并发症的2年回顾性随访

A Retrospective 2-Year Follow-up of Late Complications Treated Surgically and Endoscopically After Laparoscopic Roux-en-Y Gastric Bypass (LRYGB) and Laparoscopic Sleeve Gastrectomy (LSG) for Morbid Obesity.

作者信息

Javanainen Mervi, Penttilä Anne, Mustonen Harri, Juuti Anne, Scheinin Tom, Leivonen Marja

机构信息

Meilahti University Hospital, Haartmaninkatu 4, 00290, Helsinki, Finland.

Biomedicum Helsinki, Department of Surgery, Helsinki University Central Hospital, Haartmaninkatu 8, 00290, Helsinki, Finland.

出版信息

Obes Surg. 2018 Apr;28(4):1055-1062. doi: 10.1007/s11695-017-2967-0.

Abstract

BACKGROUND

The laparoscopic Roux-en-Y gastric bypass (LRYGB) has been the gold standard for bariatric surgery, but recently, the laparoscopic sleeve gastrectomy (LSG) has gained popularity. At present, limited data is available on the long-term complications of these two types of surgery. The aim of this retrospective study was to compare the 2-year data about late (more than 30 days after surgery) complications that were treated surgically or endoscopically after LRYGB and LSG operations in a large hospital area with a single patient database.

MATERIALS

This was a retrospective, non-randomized, single-center study of 760 (545 LRYGB and 215 LSG) bariatric patients surgically treated between 2008 and 2013 in the Bariatric Surgery Unit of Helsinki University Central Hospital.

METHODS

The patients were followed for 2 years, and late complications (more than 30 days after surgery) that were surgically and/or endoscopically treated were registered. Weight loss and the risk factors for complications were also monitored.

RESULTS

The study found a difference between the LRYGB and LSG patients in a number of late complications treated by both intervention types: surgical intervention were required in 9.4% of LRYGB patients vs. 0.9 of LSG patients, and endoscopic intervention were required by 4.6% of LRYGB patients vs. 1.4% of LSG patients (both p < 0.05). The risk of surgical complications was increased by better weight loss results in 12 months.

CONCLUSIONS

LRYGB was found to be associated with a greater risk of late complications. If larger databases confirm these results, the trend toward LSG is justified.

摘要

背景

腹腔镜Roux-en-Y胃旁路术(LRYGB)一直是减肥手术的金标准,但近年来,腹腔镜袖状胃切除术(LSG)越来越受欢迎。目前,关于这两种手术长期并发症的可用数据有限。本回顾性研究的目的是在一个拥有单一患者数据库的大医院区域,比较LRYGB和LSG手术后2年因晚期(术后超过30天)并发症而接受手术或内镜治疗的数据。

材料

这是一项回顾性、非随机、单中心研究,纳入了2008年至2013年在赫尔辛基大学中心医院减肥手术科接受手术治疗的760例减肥患者(545例行LRYGB,215例行LSG)。

方法

对患者进行2年随访,记录因晚期并发症(术后超过30天)而接受手术和/或内镜治疗的情况。同时监测体重减轻情况及并发症的危险因素。

结果

研究发现,在两种干预方式治疗的多种晚期并发症方面,LRYGB组和LSG组患者存在差异:9.4%的LRYGB患者需要手术干预,而LSG患者为0.9%;4.6%的LRYGB患者需要内镜干预,而LSG患者为1.4%(均p<0.05)。术后12个月体重减轻效果越好,手术并发症风险越高。

结论

发现LRYGB与更高的晚期并发症风险相关。如果更大的数据库证实这些结果,那么向LSG发展的趋势是合理的。

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