Erasmus Hospital, Free University of Brussels, Brussels, Belgium.
Clinique Saint Jean, Brussels, Belgium.
Acta Chir Belg. 2021 Dec;121(6):413-419. doi: 10.1080/00015458.2020.1841485. Epub 2020 Oct 28.
Laparoscopic sleeve gastrectomy (LSG) became the most frequently performed bariatric procedure worldwide, gaining rapidly popularity thanks to its technical simplicity and the relatively good results. The aim of this Belgian-French study was to evaluate postoperative complications, weight loss, and resolution of obesity-related comorbidities after LSG, and identify predictive factors of weight loss failure.
A prospective multicenter study was conducted on all LSG performed during 2014 in 7 centers. Their demographic, preoperative, and postoperative data were prospectively collected and analyzed statistically.
Overall 529 patients underwent LSG, with a mean preoperative weight and body mass index (BMI) of 118.9 ± 19.9 kg and 42.9 ± 5.5 kg/m, respectively. Postoperative mortality was null and early postoperative morbidity was 6%, including 2.5% of gastric leakage. BMI significantly decreased to 31.1 kg/m and 30.0 kg/m at 1 and 3 years, respectively ( < .001). The mean %EWL was 77.2 and 74.6% at 1 and 3 years. A significant reduction in dyslipidemia (28.0-16.8%), obstructive sleep apnea (OSAS) (34.6-23.3%) and arterial hypertension (HTN) (30.4-20.2%) was observed after 3 years, but it does not concern diabetes and gastroesophageal reflux disease (GERD). At multivariate analysis, age > 50 years old, BMI >50 kg/m and previous laparoscopic adjustable gastric banding (LAGB) remained independent predictors of weight loss failure.
LSG for morbid obesity is safe and effective. Satisfactory outcome after 3 years can be achieved regarding %EWL and some comorbidities such as dyslipidemia, OSAS, and HTN, but not diabetes and GERD. Age > 50 years old, BMI > 50 kg/m and previous LAGB were independent predictors of weight loss failure.
腹腔镜袖状胃切除术（LSG）已成为全球最常施行的减重手术，由于其技术简单且减重效果相对较好，故迅速普及。本项比利时-法国的研究旨在评估 LSG 术后并发症、体重减轻和肥胖相关合并症的缓解情况，并确定减重失败的预测因素。
对 2014 年 7 家中心施行的所有 LSG 进行前瞻性多中心研究。前瞻性收集患者的人口统计学、术前和术后数据，并进行统计学分析。
共 529 例患者行 LSG，术前平均体重和体重指数（BMI）分别为 118.9±19.9kg 和 42.9±5.5kg/m。术后无死亡病例，早期术后发病率为 6%，包括 2.5%的胃漏。BMI 在术后 1 年和 3 年分别显著下降至 31.1kg/m 和 30.0kg/m（ < .001）。体重减轻百分比（EWL）在术后 1 年和 3 年分别为 77.2%和 74.6%。术后 3 年，血脂异常（28.0-16.8%）、阻塞性睡眠呼吸暂停（OSAS）（34.6-23.3%）和动脉高血压（HTN）（30.4-20.2%）明显降低，但糖尿病和胃食管反流病（GERD）未降低。多变量分析显示，年龄>50 岁、BMI>50kg/m 和既往腹腔镜可调胃束带术（LAGB）是减重失败的独立预测因素。
LSG 治疗病态肥胖安全有效。术后 3 年时，体重减轻百分比和一些合并症（如血脂异常、OSAS 和 HTN）可获得满意的结果，但糖尿病和 GERD 除外。年龄>50 岁、BMI>50kg/m 和既往 LAGB 是减重失败的独立预测因素。
