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胃旁路术后 7 年的体重减轻和饮食模式:卓越减重中心的经验。

Weight Loss and Eating Pattern 7 Years After Sleeve Gastrectomy: Experience of a Bariatric Center of Excellence.

机构信息

Department of Medical-Surgical Sciences and Biotechnologies, Division of General Surgery and Bariatric Centre of Excellence, University of Rome "La Sapienza", Rome, Italy.

出版信息

Obes Surg. 2020 Oct;30(10):3747-3752. doi: 10.1007/s11695-020-04699-7.

Abstract

PURPOSE

Report the analysis from a single center series of consecutive primary sleeve gastrectomy (SG) on the factors affecting weight loss at long term.

MATERIALS AND METHODS

Patients submitted to primary SG with a follow-up of 7 years were screened. Weight loss was evaluated with %excess weight loss (%EWL) and %excess BMI loss (%BMIL). Weight regain (WR) was defined as in increase of 25% of the obtained %EWL and insufficient weight loss (IWL) as loss < 50% EWL. Eating behaviors were evaluated with 7 days record (7dR). All the variables potentially affecting the weight loss were cross-matched for correlation. The study population was divided in three groups: group A (WR), group B (IWL), and group C (sustained weight loss) for comparative analysis.

RESULTS

A total of 86 patients (21 M/65 F) with a preoperative BMI of 47.08 ± 6.15 kg/m were evaluated. Cumulative 7 years weight loss was as follows: 61.66 ± 22.69% EWL and 32 ± 9% EBMIL. A total of 4.6% had an IWL while 27.9% a WR. The analysis showed a significant difference among the daily calories and fats consuming, number of meals, physical activity, grazing/sweet eating habits, and adherence to follow-up (p < 0.05) between groups A and C. Cox hazard demonstrated a significant risk (p < 0.05) to WR in case of adherence to follow-up shorter than 48 months, high daily calories, and fats intake (hazard ratio (HR) range 5-9). Eight patients (9.3%) had a surgical revision.

CONCLUSION

Our data demonstrated that long-term results (7 years) of SG are strongly related to eating habits and patient's behaviors.

摘要

目的

报告单中心连续行袖状胃切除术(SG)的分析结果,以了解影响长期减重的因素。

材料与方法

筛选出随访时间超过 7 年的行原发性 SG 患者。通过计算体重减轻百分比(%EWL)和体重指数减轻百分比(%BMIL)来评估体重减轻情况。体重反弹定义为获得的%EWL 增加 25%,体重减轻不足定义为减轻量<50%EWL。采用 7 天记录(7dR)评估饮食行为。对所有可能影响减重的变量进行交叉匹配相关性分析。研究人群分为三组:A 组(体重反弹)、B 组(体重减轻不足)和 C 组(持续减重),进行比较分析。

结果

共纳入 86 例患者(21 例男性/65 例女性),术前 BMI 为 47.08±6.15kg/m2。7 年累积减重率如下:61.66±22.69%EWL 和 32±9%EBMI。4.6%的患者出现体重减轻不足,27.9%的患者出现体重反弹。分析显示,A 组和 C 组之间在每日热量和脂肪摄入、用餐次数、体力活动、零食/甜食饮食习惯以及随访依从性方面存在显著差异(p<0.05)。Cox 风险分析显示,随访时间短于 48 个月、每日热量和脂肪摄入高、随访依从性差与体重反弹风险显著相关(风险比(HR)范围为 5-9)。8 例(9.3%)患者进行了手术修正。

结论

我们的数据表明,SG 的长期结果(7 年)与饮食习惯和患者行为密切相关。

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