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单切口与传统腹腔镜袖状胃切除术治疗病态肥胖的比较:荟萃分析。

Comparison of Single-Incision and Conventional Laparoscopic Sleeve Gastrectomy for Morbid Obesity: a Meta-Analysis.

机构信息

Department of Gastrointestinal Surgery, The First Affiliated Hospital of Fujian Medical University, 20 Chazhong Road, Fuzhou, 350005, China.

Department of General Medicine, The First Affiliated Hospital of Fujian Medical University, 20 Chazhong Road, Fuzhou, 350005, China.

出版信息

Obes Surg. 2020 Jun;30(6):2186-2198. doi: 10.1007/s11695-020-04437-z.

Abstract

BACKGROUND

Single-incision laparoscopic sleeve gastrectomy (SILSG) has been proposed as an alternative to conventional laparoscopic sleeve gastrectomy (CLSG) in obese patients. This study aims to compare the surgical outcomes of these two techniques.

METHODS

A meta-analysis of existing literature obtained through a systematic literature search in the PubMed, EMBASE, and Cochrane Library CENTRAL databases from 2009 to 2019 was conducted.

RESULTS

Eleven articles including 1168 patients were analyzed. Patients in the SILSG group reported greater satisfaction with cosmetic scar outcomes than those in the CLSG group (SMD = 2.47, 95% CI = 1.10 to 3.83, P = 0.00). There was no significant difference between the SILSG group and the CLSG group regarding operative time, intraoperative estimated blood loss, conversion rate, intraoperative complications, length of hospital stay, postoperative analgesia, postoperative complications, excess weight loss (EWL), and improvements in comorbidities (P > 0.05).

CONCLUSIONS

Compared to CLSG, SILSG resulted in improved cosmetic satisfaction and showed no disadvantages in terms of surgical outcomes; thus, SILSG can serve as an alternative to CLSG for obese patients. Nonetheless, high-quality randomized controlled trials (RCTs) with large study populations and long follow-up periods are needed.

摘要

背景

单切口腹腔镜袖状胃切除术(SILSG)已被提议作为肥胖患者的传统腹腔镜袖状胃切除术(CLSG)的替代方法。本研究旨在比较这两种技术的手术结果。

方法

通过对 2009 年至 2019 年在 PubMed、EMBASE 和 Cochrane Library CENTRAL 数据库中进行的系统文献检索,对现有文献进行了荟萃分析。

结果

共分析了 11 篇文章,包括 1168 名患者。SILSG 组患者对美容疤痕结果的满意度高于 CLSG 组(SMD=2.47,95%CI=1.10 至 3.83,P=0.00)。SILSG 组和 CLSG 组在手术时间、术中估计失血量、转化率、术中并发症、住院时间、术后镇痛、术后并发症、超重减轻(EWL)和改善合并症方面无显著差异(P>0.05)。

结论

与 CLSG 相比,SILSG 改善了美容满意度,在手术结果方面没有劣势;因此,SILSG 可以作为肥胖患者 CLSG 的替代方法。然而,需要高质量的随机对照试验(RCT),具有大的研究人群和长的随访期。

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