Department of Gastrointestinal Surgery, Eastern Hospital, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Affiliated Hospital of the University of Electronic Science and Technology, Chengdu, China.
Department of Gastrointestinal Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, China.
Surg Obes Relat Dis. 2019 Apr;15(4):546-555. doi: 10.1016/j.soard.2019.02.001. Epub 2019 Feb 10.
Laparoscopic sleeve gastrectomy and laparoscopic Roux-en-Y gastric bypass (LRYGB) are 2 widely used procedures performed in bariatric surgery. However, their long-term weight loss effects have not been well compared.
To evaluate the long-term outcome of 2 procedures for treating morbid obesity.
The gastrointestinal surgery center, Eastern Hospital, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital.
Three electronic databases, PubMed, CNKI, and EMBASE, were searched ending in September 2018. Eligible studies were prospective randomized controlled trials.
Of 15 randomized controlled trials studies, 1381 cases were included, 697 were randomly divided into the laparoscopic sleeve gastrectomy group and 684 to the LRYGB group. A statistically significant percent excess weight loss reduction in weighted mean difference was observed in LRYGB group at 5 years (weighted mean difference = -8.9, 95% confidence interval [CI] = -13.08 to -4.73, P < .0001), and at 3 years (weighted mean difference = -11.96, 95% CI = -17.62 to -6.30, P < .0001). However, there was not any statistically difference between the 2 procedures in <3 years. The total complication of the LSC group were less than that of the LRYGB groups (odds ratio = .52, 95%CI = .35-.76, P = .0007). This meta-analysis showed that the LRYGB procedure could reduce gastrointestinal reflux disease (odds ratio = .26, 95%CI = .11-.61, P = .002); however, no statistically significant differences were found in type 2 diabetes, hypertension, dyslipidemia, and sleep apnea.
This meta-analysis showed that significantly greater in percent excess weight loss after 5 years of LRYGB treatment; however, it seems to have a higher incidence of total complications.
腹腔镜袖状胃切除术和腹腔镜 Roux-en-Y 胃旁路术（LRYGB）是两种广泛应用于减重手术的方法。然而，它们的长期减重效果尚未得到很好的比较。
评估两种治疗病态肥胖的手术方法的长期疗效。
四川省医学科学院四川省人民医院胃肠外科中心。
检索 2018 年 9 月前的三个电子数据库 PubMed、CNKI 和 EMBASE，纳入的研究为前瞻性随机对照试验。
在 15 项随机对照试验研究中，共纳入 1381 例患者，其中 697 例被随机分为腹腔镜袖状胃切除术组，684 例为 LRYGB 组。在 LRYGB 组，5 年时的体重减轻百分比差值的加权均数差异具有统计学意义（加权均数差值=-8.9，95%置信区间[CI]：-13.08 至-4.73，P<0.0001），3 年时也有统计学意义（加权均数差值=-11.96，95%CI：-17.62 至-6.30，P<0.0001）。然而，<3 年时两种手术方式之间没有统计学差异。LSG 组的总并发症发生率低于 LRYGB 组（比值比[OR]=0.52，95%CI：0.35-0.76，P=0.0007）。本荟萃分析表明，LRYGB 手术可降低胃食管反流病（OR=0.26，95%CI：0.11-0.61，P=0.002）的发生风险；然而，在 2 型糖尿病、高血压、血脂异常和睡眠呼吸暂停方面，两种手术方式之间无统计学差异。
本荟萃分析表明，LRYGB 治疗 5 年后的体重减轻百分比明显更大；然而，它似乎有更高的总并发症发生率。
