Singla Vitish, Aggarwal Sandeep, Garg Harshit, Kashyap Lokesh, Shende Dilip R, Agarwal Samagra
1 Department of Surgical Disciplines, All India Institute of Medical Sciences (AIIMS) , New Delhi, India .
2 Department of Anaesthesiology, All India Institute of Medical Sciences (AIIMS) , New Delhi, India .
J Laparoendosc Adv Surg Tech A. 2018 Mar;28(3):256-262. doi: 10.1089/lap.2017.0536. Epub 2017 Nov 3.
Super obese patients remain a challenge for management because of large liver size resulting in decreased work space and associated comorbidities.
To study outcomes in super obese patients undergoing Laparoscopic sleeve gastrectomy (LSG).
Retrospective data of 123 patients undergoing LSG from January 2008 to March 2015 were analyzed prospectively.
Mean age and body mass index (BMI) of 123 patients (± 2 standard deviation [SD]) were 39.9 ± 23.3 years and 55.6 ± 10.54 kg/m, respectively. Mean percentage excess weight loss (%EWL) (± 2 SD) at 1, 3, 5, and 7 years was 63% ± 36.7%, 62.3% ± 29.0%, 56.5% ± 35.8%, and 58.6% ± 40.3%, respectively. The preoperative BMI correlated with %EWL at 1 year (r = 0.0397, P = .044). Staple line leak, bleeding, deep venous thrombosis, and 30-day mortality occurred in 1.6%, 0%, 0.8%, and 0% of the patients, respectively. Stricture formation and new onset gastroesophageal reflux disease (GERD) occurred in 0.8% patients each. Of the diabetic patients, 72.2% had remission and the rest required decreased dosage of oral hypoglycemic medications. Hypertension, obstructive sleep apnea, and GERD improved in 68.2%, 100%, and 25% of the patients, respectively. However, 25% of patients had worsening in GERD symptoms.
Super obese patients undergoing LSG as the primary procedure have reasonable weight loss of 62% and 56% at 3 and 5 years, respectively, with significant resolution of comorbidities.
超级肥胖患者的管理仍然是一项挑战，因为肝脏体积大导致手术操作空间减小以及存在相关合并症。
研究接受腹腔镜袖状胃切除术（LSG）的超级肥胖患者的手术结局。
对2008年1月至2015年3月期间接受LSG的123例患者的回顾性数据进行前瞻性分析。
123例患者的平均年龄和体重指数（BMI）（±2标准差[SD]）分别为39.9±23.3岁和55.6±10.54kg/m²。1年、3年、5年和7年时的平均超重体重减轻百分比（%EWL）（±2SD）分别为63%±36.7%、62.3%±29.0%、56.5%±35.8%和58.6%±40.3%。术前BMI与1年时的%EWL相关（r = 0.0397，P = 0.044）。钉合线漏、出血、深静脉血栓形成和30天死亡率分别发生在1.6%、0%、0.8%和0%的患者中。狭窄形成和新发胃食管反流病（GERD）分别发生在0.8%的患者中。在糖尿病患者中，72.2%病情缓解，其余患者需要减少口服降糖药剂量。高血压、阻塞性睡眠呼吸暂停和GERD分别在68.2%、100%和25%的患者中得到改善。然而，25%的患者GERD症状加重。
以LSG作为主要手术方式的超级肥胖患者在3年和5年时分别有合理的体重减轻，减重率分别为62%和56%，合并症得到显著缓解。
