Elbanna Hosam, Emile Sameh, El-Hawary Galal El-Sayed, Abdelsalam Noha, Zaytoun Hossam Abdelhafiz, Elkaffas Haitham, Ghanem Ahmed
Colorectal Surgery Unit, General Surgery Department, Mansoura University Hospitals, Faculty of Medicine, Mansoura University, Mansoura City, Egypt.
Radiology Department, Tanta University Hospitals, Faculty of Medicine, Tanta University, Tanta City, Egypt.
World J Surg. 2019 Jan;43(1):199-206. doi: 10.1007/s00268-018-4749-9.
Laparoscopic sleeve gastrectomy (LSG) has achieved excellent results in treatment of morbid obesity. The present study aimed to evaluate the impact of the preoperative gastric volume, volume of the remaining gastric pouch, and volume of the resected stomach on weight loss after LSG.
Patients with morbid obesity who underwent LSG were investigated by CT volumetry before and 1 week after LSG to measure the volume of the stomach before and after the procedure, and the volume of the resected stomach was also calculated. The percentage of excess weight loss (EWL) and decrease in body mass index (BMI) at 6 months postoperatively were measured and correlated with preoperative and postoperative gastric volumes.
Forty-seven patients (44 females) were included to the study. A significant decrease in the gastric volume and BMI after LSG was noted. Preoperative gastric volume was positively correlated with preoperative BMI (r = 0.723, p < 0.00001) but not correlated with %EWL at 6 months. The volume of the remaining gastric pouch was positively correlated with BMI at 6 months postoperatively (r = 0.597, p < 0.00001) and negatively correlated with %EWL (r = -0.7495, p < 0.00001). The correlation between the size of resected stomach and %EWL was statistically insignificant, yet the mean percentage of the resected stomach was directly correlated to %EWL.
The preoperative volume of the stomach was positively correlated with baseline BMI, but not correlated with %EWL. The size of the remaining gastric pouch and the percentage of the resected stomach had significant impact on %EWL after LSG.
腹腔镜袖状胃切除术(LSG)在治疗病态肥胖方面取得了优异的效果。本研究旨在评估术前胃容积、残余胃囊容积和切除胃的容积对LSG术后体重减轻的影响。
对接受LSG的病态肥胖患者在LSG术前和术后1周进行CT容积测量,以测量手术前后胃的容积,并计算切除胃的容积。测量术后6个月的超重体重减轻百分比(EWL)和体重指数(BMI)下降情况,并将其与术前和术后胃容积进行相关性分析。
47例患者(44例女性)纳入研究。LSG术后胃容积和BMI显著下降。术前胃容积与术前BMI呈正相关(r = 0.723,p < 0.00001),但与术后6个月的EWL百分比无关。残余胃囊容积与术后6个月的BMI呈正相关(r = 0.597,p < 0.00001),与EWL百分比呈负相关(r = -0.7495,p < 0.00001)。切除胃的大小与EWL百分比之间的相关性无统计学意义,但切除胃的平均百分比与EWL百分比直接相关。
术前胃容积与基线BMI呈正相关,但与EWL百分比无关。残余胃囊的大小和切除胃的百分比对LSG术后的EWL百分比有显著影响。