印度人群中腹腔镜袖状胃切除术的中远期结果：3-7 年的结果 - 一项回顾性队列研究。
Mid to long term outcomes of Laparoscopic Sleeve Gastrectomy in Indian population: 3-7 year results - A retrospective cohort study.
机构信息
Department of Surgical Disciplines, All India Institute of Medical Sciences (AIIMS), New Delhi 110029, India.
Department of Anaesthesiology and Critical Care, All India Institute of Medical Sciences (AIIMS), New Delhi 110029, India.
出版信息
Int J Surg. 2017 Dec;48:201-209. doi: 10.1016/j.ijsu.2017.10.076. Epub 2017 Nov 6.
INTRODUCTION
Few studies have addressed the mid to long term impact of Laparoscopic Sleeve Gastrectomy (LSG) on weight loss and obesity associated co-morbidities, particularly in Indian population. The aim of this study is to assess the efficacy of LSG in morbid obesity over 3-7 years follow up.
MATERIALS AND METHODS
Data of all patients who underwent LSG between January 2008 and March 2015 and completed their at least 1 year follow up till March 2016 was retrospectively reviewed using a prospectively collected database.
RESULTS
424 patients undergoing primary LSG were included. The mean age (±2SD) was 39.8 ± 22.5 years and the mean Body Mass Index (BMI) (±2SD) was 46.67 ± 15.8 kg/m. 124 patients (29.2%) were super-obese (BMI >50 kg/m). The percentage follow-up at 1 year, 3 years, 5 years and 7 years was 78.3%, 66.7%, 42.3% and 38.4% respectively. The mean percentage Excess weight Loss (%EWL) (±2SD) at 1year, 3years, 5years, and 7years was 71.8 (±50.5%), 64.95% (±41.8%), 61.7% (±46.2%) and 57.15% (±50.2%) respectively. The preoperative BMI significantly correlated with %EWL at 5 year (r = 0.107, p = 0.018). The overall complication rate was 5.8%. Early complications included staple line leak (1.2%), bleeding (1.2%), deep venous thrombosis (0.4%) and 30-day mortality (0.21%). Late complications included stricture formation (0.21%) and new onset Gastro-esophageal Reflux Disease (GERD) (2.8%).At 5 years, 83.3% of diabetic patients showed remission while rest showed improvement in glycemic control with decrease in dosage. 69.3% patients showed improvement in hypertension, 100% patients showed improvement in Obstructive Sleep Apnea Syndrome, 75% patients showed improvement in hypothyroidism after surgery. GERD resolved in 62.8% patients while worsened in 11.4% patients.
CONCLUSIONS
LSG has durable weight loss at 5 year with %EWL of 61% and significant resolution of obesity associated co-morbidities.
简介
很少有研究探讨腹腔镜袖状胃切除术（LSG）对体重减轻和肥胖相关合并症的中长期影响，尤其是在印度人群中。本研究旨在评估 LSG 在肥胖症患者中的疗效，随访时间为 3-7 年。
材料与方法
回顾性分析了 2008 年 1 月至 2015 年 3 月期间接受 LSG 治疗且至少随访 1 年至 2016 年 3 月的所有患者的数据，使用前瞻性收集的数据库进行分析。
结果
共纳入 424 例接受初次 LSG 的患者。平均年龄（±2SD）为 39.8±22.5 岁，平均体重指数（BMI）（±2SD）为 46.67±15.8kg/m²。124 例患者（29.2%）为超级肥胖（BMI>50kg/m²）。1 年、3 年、5 年和 7 年的随访率分别为 78.3%、66.7%、42.3%和 38.4%。1 年、3 年、5 年和 7 年时的平均多余体重减轻百分比（%EWL）（±2SD）分别为 71.8%（±50.5%）、64.95%（±41.8%）、61.7%（±46.2%）和 57.15%（±50.2%）。术前 BMI 与 5 年时的 EWL 显著相关（r=0.107，p=0.018）。总并发症发生率为 5.8%。早期并发症包括吻合口漏（1.2%）、出血（1.2%）、深静脉血栓形成（0.4%）和 30 天死亡率（0.21%）。晚期并发症包括狭窄形成（0.21%）和新发胃食管反流病（GERD）（2.8%）。5 年后，83.3%的糖尿病患者病情缓解，其余患者血糖控制改善，剂量减少。69.3%的高血压患者得到改善，100%的阻塞性睡眠呼吸暂停综合征患者得到改善，75%的甲状腺功能减退症患者术后得到改善。GERD 在 62.8%的患者中得到缓解，在 11.4%的患者中恶化。
结论
LSG 可在 5 年内保持持久的减重效果， EWL 达到 61%，显著改善肥胖相关合并症。
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