WakeMed Bariatric Specialists of NC, Cary, North Carolina.
Bariatric Medicine Institute, South Salt Lake City, Utah.
Surg Obes Relat Dis. 2020 Jan;16(1):24-33. doi: 10.1016/j.soard.2019.10.008. Epub 2019 Oct 17.
The sleeve gastrectomy (SG), Roux-en-Y gastric bypass (RYGB), and single-anastomosis duodenal-ileal bypass with SG (SADI-S) are recognized bariatric procedures. A comparison has never been made between these 3 procedures and especially in different body mass index (BMI) categories.
The study aimed to analyze a large cohort of patients undergoing either laparoscopic (L) SG, LRYGB, or LSADI-S to evaluate and compare weight loss and glycosylated hemoglobin level. The secondary aim was to compare the nutritional outcomes between LRYGB and LSADI-S.
Private practice, United States.
This is a retrospective review of 878 patients who underwent LSG, LRYGB, or LSADI-S from April 2014 through October 2015 by 5 surgeons in a single institution. For weight loss analysis, the patients were categorized into 4 different categories as follows: patients regardless of their preoperative BMI, patients with preoperative BMI <45 kg/m, patients with preoperative BMI 45 to 55 kg/m, and patients with preoperative BMI >55 kg/m.
A total of 878 patients were identified for analysis. Of 878 patients, 448 patients, 270 patients, and 160 patients underwent LSG, LRYGB, and LSADI-S, respectively. Overall, at 12 and 24 months, the weight loss was highest with LSADI-S, followed by LRYGB and LSG in all 4 categories. At 2 years, the patients lost 19.5, 16.1, and 11.3 BMI points after LSADI-S, LRYGB, and LSG, respectively. In addition, the weight loss was highest in patients with preoperative BMI <45 kg/m and lowest in patients with preoperative BMI >55 kg/m at 12 and 24 months. Also, there were no statistically significant differences between the nutritional outcomes between LRYGB and LSADI-S. The LSADI-S had significantly lower rates of abnormal glycosylated hemoglobin than LRYGB and LSG at 12 months (P < .001).
The weight loss outcomes and glycosylated hemoglobin rates were better with LSADI-S than LRYGB or LSG. The nutritional outcomes between LRYGB and LSADI-S were similar.
袖状胃切除术（SG）、Roux-en-Y 胃旁路术（RYGB）和单吻合口十二指肠-空肠旁路术联合 SG（SADI-S）是公认的减重手术。这 3 种手术之间从未进行过比较，尤其是在不同的体重指数（BMI）类别中。
本研究旨在分析一组接受腹腔镜（L）SG、LRYGB 或 LSADI-S 的患者，以评估和比较减重和糖化血红蛋白水平。次要目的是比较 LRYGB 和 LSADI-S 的营养结局。
美国私人诊所。
这是一项回顾性研究，共纳入 2014 年 4 月至 2015 年 10 月期间由 5 名外科医生在一家机构中进行的 878 例 LSG、LRYGB 或 LSADI-S 患者。为了进行减重分析，患者被分为以下 4 个不同类别：无论术前 BMI 如何的患者、术前 BMI<45kg/m 的患者、术前 BMI 为 45 至 55kg/m 的患者和术前 BMI>55kg/m 的患者。
共纳入 878 例患者进行分析。878 例患者中，448 例、270 例和 160 例分别接受了 LSG、LRYGB 和 LSADI-S。总体而言，在所有 4 个类别中，LSADI-S 在 12 个月和 24 个月时的减重效果最高，其次是 LRYGB 和 LSG。2 年后，LSADI-S、LRYGB 和 LSG 组患者分别减重 19.5、16.1 和 11.3 BMI 点。此外，术前 BMI<45kg/m 的患者在 12 个月和 24 个月时减重效果最高，而术前 BMI>55kg/m 的患者减重效果最低。此外，LRYGB 和 LSADI-S 之间的营养结局无统计学差异。LSADI-S 在 12 个月时的糖化血红蛋白异常率明显低于 LRYGB 和 LSG（P<0.001）。
LSADI-S 的减重效果和糖化血红蛋白水平优于 LRYGB 或 LSG。LRYGB 和 LSADI-S 的营养结局相似。
