Bariatric and Metabolic Surgery Unit, Section of Gastrointestinal Surgery, Hospital del Mar, Barcelona, Spain.
Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.
Obes Surg. 2020 Jun;30(6):2199-2205. doi: 10.1007/s11695-020-04445-z.
The volume of the gastric reservoir (VGR) after sleeve gastrectomy influences weight loss in the short-term, but long-term results are scarce. The aim was to analyze the correlation between the VGR and weight loss at 5 years of follow-up.
It is a prospective observational study of 50 patients undergoing sleeve gastrectomy (SG) from February 2009 to December 2013. An upper gastrointestinal series was performed at 1 month and at 1 and 5 years after surgery. A composite formula was used for VGR estimation. Weight loss-related data included the following: body mass index (BMI), percentage of excess weight loss (%EWL), and percentage of excess BMI loss (%EBMIL) at 1 month and at 1 and 5 years. Uni- and multivariate analyses were carried out to determine other factors that might influence long-term weight loss results.
The %EWL at 1 year was 74.5(63.8-86) vs. 55.5(47-74.3) at 5 years (p < 0.001). The VGR 1 month after surgery was 114.9 (90.5-168.3) mL. The VGR increased from 216.7 (155.1-278.6) to 367.5 (273-560.3) mL (p < 0.001) at 1 and 5 years. Although a significant inverse correlation was observed between VGR and BMI, %EWL, and %EBMIL at 1 year, it disappeared at 5 years. In the multivariate analysis, the main factor to predict worse weight results at 5 years was a pre-surgical BMI ≥ 50 kg/m.
The VGR increased progressively during the study period. Although an inverse relationship between VGR and weight was found at 1 year, this correlation did not remain at 5 years. A preoperative BMI ≥ 50 kg/m is the main predictive factor of poor weight outcomes.
袖状胃切除术(SG)后的胃容量(VGR)会影响短期减重效果,但长期结果较为缺乏。本研究旨在分析 VGR 与术后 5 年随访期间减重效果之间的相关性。
这是一项前瞻性观察研究,纳入了 2009 年 2 月至 2013 年 12 月期间行 SG 的 50 例患者。术后 1 个月、1 年和 5 年分别行上消化道造影。采用复合公式估计 VGR。与减重相关的数据包括:术后 1 个月和 1 年及 5 年时的体重指数(BMI)、体重减轻百分比(%EWL)和 BMI 减轻百分比(%EBMIL)。采用单因素和多因素分析确定可能影响长期减重效果的其他因素。
术后 1 年时的 %EWL 为 74.5(63.8-86),而术后 5 年时为 55.5(47-74.3)(p<0.001)。术后 1 个月时的 VGR 为 114.9(90.5-168.3)mL。术后 1 年和 5 年时 VGR 分别增加至 216.7(155.1-278.6)和 367.5(273-560.3)mL(p<0.001)。尽管术后 1 年时 VGR 与 BMI、%EWL 和 %EBMIL 呈显著负相关,但 5 年后这种相关性消失。多因素分析表明,预测术后 5 年减重效果较差的主要因素是术前 BMI≥50kg/m。
VGR 在研究期间逐渐增加。尽管术后 1 年时 VGR 与体重呈负相关,但 5 年后这种相关性不再存在。术前 BMI≥50kg/m 是预测减重效果不佳的主要因素。