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2005 年至 2016 年德国减重手术注册中心的袖状胃切除术:围手术期和 5 年结果。

Sleeve gastrectomy in the German Bariatric Surgery Registry from 2005 to 2016: Perioperative and 5-year results.

机构信息

Municipal Hospital Karlsruhe, Karlsruhe, Germany.

SRH Municipal Hospital Gera, Gera, Germany; Institute of Quality Assurance at Otto-von Guericke University Magdeburg, Magdeburg, Germany.

出版信息

Surg Obes Relat Dis. 2019 Feb;15(2):187-193. doi: 10.1016/j.soard.2018.11.005. Epub 2018 Nov 14.

Abstract

BACKGROUND

Recently, sleeve gastrectomy (SG) has become one of the most important procedures in bariatric surgery. Short-term results show that SG is a feasible, safe, and effective operation treating obesity and its related co-morbidities. Now, the main focus is on long-term data after SG.

OBJECTIVES

The aim of this study was to analyze perioperative and long-term results after SG in the German Bariatric Surgery Registry.

SETTING

National database, Germany.

METHODS

Perioperative data of primary SG (n = 21525) and follow-up data for 5 years ± 6 months (n = 435, 18.3% of 2375 SG performed between 2005 and 2011) were analyzed. After a review of the literature long-term results were compared with international data.

RESULTS

Mean baseline body mass index (BMI) was 51.1 kg/m. Two hundred ninety-eight (68.5%) patients were female and 137 (31.5%) were male. Of patients, 90% had ≥1 co-morbidities. Mean operation time was 86 minutes. General postoperative complications occurred in 4.1% and special complications in 4.6% (staple-line leaks 1.6%). Mean maximum BMI loss was 18.0 ± 6.8 kg/m and BMI loss after 5 years was 14.3 ± 7.4 kg/m (P < .001). Co-morbidities, such as type 2 diabetes, hypertension, and sleep apnea, were significantly improved (P < .001). Gastroesophageal reflux was significantly impaired (P < .001).

CONCLUSIONS

The current results showed that SG is a safe and effective procedure in bariatric surgery. BMI loss was significant 5 years after SG. Most co-morbidities were significantly improved, but gastroesophageal reflux has often worsened. The follow-up rate was very low, which is a persistent problem in German bariatric surgery.

摘要

背景

最近,袖状胃切除术(SG)已成为减重手术中最重要的程序之一。短期结果表明,SG 是一种可行、安全且有效的治疗肥胖及其相关合并症的手术。现在,主要关注的是 SG 后的长期数据。

目的

本研究旨在分析德国减重手术注册中心 SG 的围手术期和长期结果。

设置

德国国家数据库。

方法

分析了首次 SG 的围手术期数据(n=21525)和 5 年±6 个月的随访数据(n=435,占 2005 年至 2011 年间进行的 2375 例 SG 的 18.3%)。在对文献进行回顾后,将长期结果与国际数据进行了比较。

结果

平均基线体重指数(BMI)为 51.1kg/m2。298 例(68.5%)患者为女性,137 例(31.5%)为男性。90%的患者有≥1 种合并症。平均手术时间为 86 分钟。术后总并发症发生率为 4.1%,特殊并发症发生率为 4.6%(吻合口漏 1.6%)。平均最大 BMI 减轻量为 18.0±6.8kg/m2,5 年后 BMI 减轻量为 14.3±7.4kg/m2(P<.001)。2 型糖尿病、高血压和睡眠呼吸暂停等合并症明显改善(P<.001)。胃食管反流明显受损(P<.001)。

结论

目前的结果表明,SG 是一种安全有效的减重手术方法。SG 后 5 年 BMI 减轻量显著。大多数合并症明显改善,但胃食管反流通常恶化。随访率非常低,这是德国减重手术中一个持续存在的问题。

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