Guilbert L, Joo P, Ortiz C, Sepúlveda E, Alabi F, León A, Piña T, Zerrweck C
Clínica Integral de Cirugía para la Obesidad y Enfermedades Metabólicas del Hospital General Tláhuac, Ciudad de México, México.
Clínica Integral de Cirugía para la Obesidad y Enfermedades Metabólicas del Hospital General Tláhuac, Ciudad de México, México.
Rev Gastroenterol Mex (Engl Ed). 2019 Jul-Sep;84(3):296-302. doi: 10.1016/j.rgmx.2018.05.002. Epub 2018 Jun 20.
Bariatric surgery is the best method for treating obesity and its comorbidities. Our aim was to provide a detailed analysis of the perioperative outcomes in Mexican patients that underwent surgery at a high-volume hospital center.
A retrospective study was conducted on all the patients that underwent bariatric surgery at a single hospital center within a time frame of 4 and one-half years. Demographics, the perioperative variables, complications (early and late), weight loss, failure, and type 2 diabetes mellitus remission were all analyzed.
Five hundred patients were included in the study, 83.2% of whom were women. Mean patient age was 38.8 years and BMI was 44.1kg/m. The most common comorbidities were high blood pressure, dyslipidemia, and diabetes. Laparoscopic gastric bypass surgery was performed in 85.8% of the patients, sleeve gastrectomy in 13%, and revision surgeries in 1%. There were 9.8% early complications and 12.2% late ones, with no deaths. Overall weight loss as the excess weight loss percentage at 12 and 24 months was 76.9 and 77.6%. The greatest weight loss at 12 months was seen in the patients that underwent laparoscopic gastric bypass. A total of 11.4% of the patients had treatment failure. In the patients with type 2 diabetes mellitus, 68.7% presented with complete disease remission and 9.3% with partial remission. There was improvement in 21.8% of the cases.
In our experience at a high-volume hospital center, bariatric surgery is safe and effective, based on the low number of adverse effects and consequent weight loss and type 2 diabetes mellitus control. Long-term studies with a larger number of patients are needed to determine the final impact of those procedures.
减重手术是治疗肥胖及其合并症的最佳方法。我们的目的是对在一家大型医院中心接受手术的墨西哥患者的围手术期结果进行详细分析。
对在一家医院中心4年半时间内接受减重手术的所有患者进行回顾性研究。分析了人口统计学、围手术期变量、并发症（早期和晚期）、体重减轻、治疗失败情况以及2型糖尿病缓解情况。
500名患者纳入研究，其中83.2%为女性。患者平均年龄38.8岁，体重指数为44.1kg/m。最常见的合并症为高血压、血脂异常和糖尿病。85.8%的患者接受了腹腔镜胃旁路手术，13%接受了袖状胃切除术，1%接受了翻修手术。早期并发症发生率为9.8%，晚期并发症发生率为12.2%，无死亡病例。以超重减轻百分比计算，12个月和24个月时的总体体重减轻分别为76.9%和77.6%。12个月时体重减轻最多的是接受腹腔镜胃旁路手术的患者。共有11.4%的患者治疗失败。在2型糖尿病患者中，68.7%实现了疾病完全缓解，9.3%实现了部分缓解。21.8%的病例病情有所改善。
根据我们在大型医院中心的经验，基于不良反应数量少以及随之而来的体重减轻和2型糖尿病得到控制，减重手术是安全有效的。需要对更多患者进行长期研究以确定这些手术的最终影响。
