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使用吻合器和胃造口术的全层内镜下胃切除术:一项可行性研究。

FULL-THICKNESS ENDOSCOPIC GASTRIC RESECTION USING A STAPLER AND GASTROSTOMY: A FEASIBILITY STUDY.

作者信息

Wada André M, Hashiba Kiyoshi, Otoch Jose P, Brasil Horus, Marson Fernando P, Cassab Jorge, Abdalla Ricardo, Artifon Everson L A

机构信息

Department of Surgery, University of São Paulo.

Sírio Libanês Institute for Teaching and Research, São Paulo, SP, Brazil.

出版信息

Arq Bras Cir Dig. 2018 Aug 16;31(3):e1386. doi: 10.1590/0102-672020180001e1386.

Abstract

BACKGROUND

Laparoscopic sleeve gastrectomy (LSG) is currently the most frequently performed bariatric procedure in Turkey. The goal of weight reduction surgery is not only to decrease excess weight, but also to improve obesity related comorbidities and quality of life (QoL).

AIM

To evaluate the impact of LSG on patient quality of life, weight loss, and comorbidities associated with morbid obesity according to the updated BAROS criteria.

METHODS

Eleven hundred thirty-eight adult patients were undergone to LSG by our bariatric surgery team between January 2013 and January 2016. A questionnaire (The Bariatric Analysis and Reporting Outcome System - BAROS) was published on social media. The data on postoperative complications were collected from hospital database.

RESULTS

Number of respondants was 562 (49.4%). Six of 1138 patients(0.5%) had leakage. All patients who had leakage were respondants. The overall complication rate was 7.7%. After a mean period of 7.4±5.3 months(1-30), mean excess weight loss was 71.3±27.1% (10.2-155.4). The respondants reported 772 comorbidities. Of these, 162 (30%) were improved, and 420 (54.4%) were resolved. The mean scores for QoL were significantly increased after LSG (range, p<0.05 to <0.001). Of the 562 patients, 26 (4.6%) were classified as failures; 86 (15.3%) fair; 196 (34.9%) good; 144 (25.6%) very good, and 110 (19.6%) excellent results according to the updated BAROS scoring system.

CONCLUSION

LSG is a highly effective bariatric procedure in the manner of weight control, improvement in comorbidities and increasing of QoL in short- and mid-term.

摘要

背景

腹腔镜袖状胃切除术(LSG)目前是土耳其最常实施的减肥手术。减重手术的目标不仅是减轻超重体重,还包括改善肥胖相关的合并症及生活质量(QoL)。

目的

根据更新后的BAROS标准,评估腹腔镜袖状胃切除术对患者生活质量、体重减轻及与病态肥胖相关合并症的影响。

方法

2013年1月至2016年1月期间,我们的减肥手术团队对1138例成年患者实施了腹腔镜袖状胃切除术。在社交媒体上发布了一份调查问卷(减肥分析与报告结果系统 - BAROS)。术后并发症数据从医院数据库收集。

结果

应答者数量为562例(49.4%)。1138例患者中有6例(0.5%)发生渗漏。所有发生渗漏的患者均为应答者。总体并发症发生率为7.7%。平均7.4±5.3个月(1 - 30个月)后,平均超重减轻率为71.3±27.1%(10.2 - 155.4)。应答者报告了772种合并症。其中,162种(30%)得到改善,420种(54.4%)得到解决。腹腔镜袖状胃切除术后生活质量的平均得分显著提高(范围,p<0.05至<0.001)。根据更新后的BAROS评分系统,562例患者中,26例(4.6%)被归类为失败;86例(15.3%)为一般;196例(34.9%)为良好;144例(25.6%)为非常好,110例(19.6%)为优秀结果。

结论

腹腔镜袖状胃切除术在短期和中期对体重控制、改善合并症及提高生活质量方面是一种高效的减肥手术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5a32/6097028/680ccf6b53ce/0102-6720-abcd-31-03-e1386-gf1.jpg

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