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超级肥胖患者行单吻合口胃旁路术或腹腔镜袖状胃切除术的结局。

Outcomes in Super Obese Patients Undergoing One Anastomosis Gastric Bypass or Laparoscopic Sleeve Gastrectomy.

机构信息

Department of Surgical Disciplines, All India Institute of Medical Sciences (AIIMS), New Delhi, 110029, India.

出版信息

Obes Surg. 2019 Apr;29(4):1242-1247. doi: 10.1007/s11695-018-03673-8.

Abstract

INTRODUCTION

The data on the role of OAGB in super obese patients and its direct comparison with LSG in super obese patients is scarce.

OBJECTIVES

To compare weight loss, impact on comorbidities and nutritional parameters between LSG and OAGB in super obese patients.

METHODS

Prospectively collected data of 75 matched patients with BMI > 50, who underwent either laparoscopic sleeve gastrectomy (LSG) or one anastomosis gastric bypass (OAGB), was analyzed retrospectively. Percentage excess weight loss at 1 year and impact on comorbidities were compared in both the groups.

RESULTS

Both the groups were comparable for age, sex, BMI, and presence or absence of diabetes mellitus. Mean TWL% ± 2SD at 1 year was 30.09% ± 19.76 in patients undergoing LSG, while it was 39.9% ± 12.78 in patients undergoing OAGB (p < 0.001). In the LSG group, 85.7% and 66.67% of patients had remission of diabetes mellitus and hypertension, respectively, as compared to 77.77% and 78.5%, respectively, in the OAGB group. All the patients with OSA had a resolution of their symptoms in both the groups. Patients in the OAGB group became more folate deficient despite regular supplementation.

CONCLUSION

Weight loss following OAGB was found to be better than LSG in the super obese patients in our study. There was a similar resolution of comorbidities and a lesser rate of major complications in the OAGB group.

摘要

简介

关于 OAGB 在超级肥胖患者中的作用及其与 LSG 在超级肥胖患者中的直接比较的数据很少。

目的

比较超级肥胖患者中 LSG 和 OAGB 的体重减轻、对合并症的影响和营养参数。

方法

回顾性分析了 75 例 BMI>50 的匹配患者的前瞻性收集数据,这些患者接受了腹腔镜袖状胃切除术(LSG)或单吻合胃旁路术(OAGB)。比较两组患者术后 1 年的超重体重减轻百分比和对合并症的影响。

结果

两组患者的年龄、性别、BMI 和是否合并糖尿病无差异。LSG 组患者术后 1 年的平均 TWL%±2SD 为 30.09%±19.76%,而 OAGB 组为 39.9%±12.78%(p<0.001)。LSG 组中,85.7%和 66.67%的糖尿病患者和高血压患者分别得到缓解,而 OAGB 组中分别为 77.77%和 78.5%。两组所有 OSA 患者的症状均得到缓解。尽管补充了叶酸,但 OAGB 组的患者叶酸缺乏症更为严重。

结论

在我们的研究中,OAGB 术后体重减轻优于 LSG。OAGB 组的合并症缓解率相似,但严重并发症发生率较低。

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