Department of Surgery, University of Alberta, Edmonton, Alberta, Canada.
Department of Surgery, University of Alberta, Edmonton, Alberta, Canada.
Surg Obes Relat Dis. 2019 Apr;15(4):629-635. doi: 10.1016/j.soard.2019.01.024. Epub 2019 Feb 1.
Bariatric surgery is an effective treatment for severe obesity. However, there has been an evolving role for bariatric surgery as a primary treatment in the management of class I obesity.
We aimed to assess the safety of surgery by directly comparing surgical outcomes of laparoscopic sleeve gastrectomy (LSG) and laparoscopic Roux-en-Y gastric bypass (LRYGB) in class I obesity (body mass index [BMI] 30-35 kg/m) with those with class II obesity (BMI 35-40 kg/m) and higher (BMI >40 kg/m) using an analysis of a large-scale matched-patient cohort analysis.
Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program database, United States and Canada.
We performed a retrospective analysis using the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program database, which collects patient information from >790 bariatric surgery centers in North America. Patients included in our analysis underwent surgery in the years 2015 and 2016 and had either LRYGB or LSG for weight loss.
Initial analysis included 274,091 patients. Propensity-matching resulted in 9104 patients for analysis in each of the class I and class II and higher groups. The overall major complication rate between the 2 matched groups was 3.9% for class I and 3.5% for class II and higher (P = .11). We did not find that class I obesity was associated with an increased risk of 30-day complication or death.
In our analysis of propensity-matched patients undergoing LSG and LRYGB for weight loss, class I obesity did not have statistically higher risk of postoperative complication rates compared with class II and higher.
减重手术是治疗重度肥胖的有效方法。然而，减重手术作为肥胖 I 级（BMI 为 30-35kg/m²）患者的主要治疗方法的作用正在不断演变。
我们旨在通过对接受腹腔镜袖状胃切除术（LSG）和腹腔镜 Roux-en-Y 胃旁路术（LRYGB）的肥胖 I 级（BMI 为 30-35kg/m²）患者与肥胖 II 级（BMI 为 35-40kg/m²）和更高（BMI >40kg/m²）患者的手术结局进行直接比较，评估手术的安全性，使用大型匹配患者队列分析进行分析。
美国和加拿大的代谢和减重手术认证和质量改进计划数据库。
我们使用代谢和减重手术认证和质量改进计划数据库进行回顾性分析，该数据库从北美 790 多个减重手术中心收集患者信息。我们的分析纳入了 2015 年和 2016 年接受减重手术的患者，他们接受的手术方式为 LRYGB 或 LSG。
初步分析包括 274091 名患者。倾向匹配后，每组 I 级和 II 级及以上组分别有 9104 名患者纳入分析。两组间总体主要并发症发生率分别为 I 级组 3.9%，II 级及以上组 3.5%（P=0.11）。我们没有发现肥胖 I 级与 30 天并发症或死亡风险增加相关。
在对接受 LSG 和 LRYGB 减重的倾向匹配患者进行的分析中，肥胖 I 级与术后并发症发生率较高无统计学关联。
