William Beaumont Army Medical Center, 5005 N. Piedras, El Paso, TX, 79920, USA.
Madigan Army Medical Center, Tacoma, WA, USA.
Obes Surg. 2019 Jan;29(1):93-98. doi: 10.1007/s11695-018-3473-8.
Polycystic ovarian syndrome (PCOS) is a common endocrine disorder associated with obesity and infertility. Gastric bypass has been shown to be effective in treating these symptoms. However, the efficacy of vertical sleeve gastrectomy (VSG) has not been studied in the PCOS population. This study analyzed weight loss and fertility outcomes of VSG in this population.
A retrospective review of patients with PCOS and without PCOS (CON) undergoing VSG from 2008 to 2016 was performed at two bariatric centers. BMI and percent excess weight loss (%EWL) were collected at 3, 6, and 12 months postoperatively. Patient characteristics and postoperative pregnancy status were compared between the two cohorts.
One hundred nineteen PCOS patients were compared to 119 CON patients. Similar attrition rates were seen between cohorts at 3-month (5 vs 8%), 6-month (13 vs. 14%), and 12-month (18 vs. 13%) evaluation. PCOS patients had greater ΔBMI at 3 months (- 7.64 vs. - 6.82; p = 0.05), 6 months (- 10.56 vs. - 9.49; p = 0.02), and 12 months (- 12.43 vs. - 11.49; p = 0.04). PCOS patients also had greater %EWL at 12 months compared to CON (66 vs 60%; p = 0.05). Twenty-two percent of PCOS patients became pregnant within 12 months, 69% of which were previously nulliparous.
Compared to non-PCOS patients, PCOS patients had greater postoperative ΔBMI and %EWL at 1 year. The majority of patients becoming pregnant after VSG were previously nulliparous. This study shows that VSG is effective for weight loss in PCOS patients with obesity and may positively augment effect fertility rates.
多囊卵巢综合征（PCOS）是一种常见的与肥胖和不孕相关的内分泌疾病。胃旁路术已被证明对这些症状有效。然而，垂直袖状胃切除术（VSG）在 PCOS 人群中的疗效尚未得到研究。本研究分析了 VSG 在该人群中的减肥和生育结果。
对 2008 年至 2016 年在两家减肥中心接受 VSG 的 PCOS 患者和非 PCOS（CON）患者进行了回顾性研究。在术后 3、6 和 12 个月收集 BMI 和体重减轻百分比（%EWL）。比较两组患者的特征和术后妊娠情况。
119 例 PCOS 患者与 119 例 CON 患者进行了比较。两组在 3 个月（5%对 8%）、6 个月（13%对 14%）和 12 个月（18%对 13%）评估时的失访率相似。PCOS 患者在 3 个月（-7.64 对-6.82；p=0.05）、6 个月（-10.56 对-9.49；p=0.02）和 12 个月（-12.43 对-11.49；p=0.04）时 BMI 的下降更大。PCOS 患者在 12 个月时的 EWL%也高于 CON（66%对 60%；p=0.05）。22%的 PCOS 患者在 12 个月内怀孕，其中 69%为初产妇。
与非 PCOS 患者相比，PCOS 患者在 1 年内 BMI 下降和 EWL%更高。大多数在 VSG 后怀孕的患者以前从未生育过。本研究表明，VSG 对肥胖 PCOS 患者的减肥有效，并且可能对提高生育率产生积极影响。
