Department of Surgery, Faculty of Medicine, Selcuk University, Selcuklu, 42075, Konya, Turkey.
Obes Surg. 2021 May;31(5):2062-2071. doi: 10.1007/s11695-020-05212-w. Epub 2021 Jan 6.
The aim of this study was to compare the postoperative metabolic and nutritional outcomes after transit bipartition with sleeve gastrectomy (TB-SG) and distal-Roux-en-Y gastric bypass (D-RYGB).
A retrospective evaluation was made of 109 morbidly obese patients who underwent TB-SG or D-RYGB. Primary outcomes included metabolic variables such as glycemic control and serum lipid levels, and secondary outcomes consisted of nutritional deficiencies and weight loss after surgical procedures.
During the study period, 83 and 26 patients underwent D-RYGB and TB-SG, respectively. The preoperative characteristics and nutritional status of the groups were similar. D-RYGB resulted in significantly higher weight loss rates in the first 3 months, but the percentage of excess weight loss (EWL %) was not different in the 12-month follow-up period. Although D-RYGB provided faster glycemic control due to early weight loss, there was no difference between the two groups. At the end of the follow-up period, the TB-SG was associated with significantly less deficiency of vitamin D, vitamin B12, iron, and folic acid. Anastomosis leakage was more common in the D-RYGB technique. The overall complication rates of the groups were similar.
TB-SG is a safe and effective alternative to D-RYGB for the treatment of obesity-related metabolic disorders with fewer nutritional deficiencies.
本研究旨在比较经 Transit 分区与袖状胃切除术（TB-SG）和远端胃旁路术（D-RYGB）治疗后患者的术后代谢和营养结局。
回顾性评估了 109 例接受 TB-SG 或 D-RYGB 的病态肥胖患者。主要结局包括血糖控制和血清脂质水平等代谢变量，次要结局包括手术后的营养缺乏和体重减轻。
研究期间，83 例患者接受了 D-RYGB，26 例患者接受了 TB-SG。两组患者的术前特征和营养状况相似。D-RYGB 在术后前 3 个月的体重减轻率明显更高，但在 12 个月的随访期间，两组的 excess weight loss（EWL）% 没有差异。尽管 D-RYGB 由于早期体重减轻而导致血糖控制更快，但两组之间没有差异。在随访期末，TB-SG 与维生素 D、维生素 B12、铁和叶酸缺乏的发生率明显较低有关。D-RYGB 技术的吻合口漏发生率更高。两组的总体并发症发生率相似。
TB-SG 是治疗肥胖相关代谢紊乱的一种安全有效的替代方法，与 D-RYGB 相比，它的营养缺乏更少。
