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腹腔镜带袖套胃切除术:单中心四年随访经验。

Laparoscopic Banded Sleeve Gastrectomy: Single-Center Experience with a Four-Year Follow-Up.

机构信息

Obesity Unit, Department of Surgery and University of Rome "Tor Vergata," Rome, Italy.

Department of Systems Medicine, University of Rome "Tor Vergata," Rome, Italy.

出版信息

J Laparoendosc Adv Surg Tech A. 2021 Nov;31(11):1269-1273. doi: 10.1089/lap.2020.0726. Epub 2021 Jan 15.

Abstract

Laparoscopic sleeve gastrectomy (LSG) is now the most common bariatric procedure to treat morbidly obese patients. The main concern of LSG lies in the long-term weight regain, which is reported to happen in up to 75.6% of patients after 6 years. In this study, we report our overall experience with Laparoscopic Banded Sleeve Gastrectomy (LBSG) using the MiniMizer over a 6-year period. We performed a retrospective review of data from a prospectively collected database. All patients submitted to primary LBSG were examined. Patients were submitted to LBSG between February 2014 and January 2020. Collected data included demographic factors, preoperative body mass index (BMI), operative time, surgical complications, and clinical outcomes. Two hundred nine patients were submitted to primary LBSG in the study period. They were 136 females (65%) and 73 males (35%) with a median age of 43.0 years (range, 18-65 years). Median preoperative BMI was 48.4 kg/m (range, 36.2-65.5 kg/m). Median operative time was 72.0 minutes (range, 40-142 minutes). Median time for ring placement was 8.0 minutes. Median postoperative hospital stay was 2.8 days. Seven major complications occurred in the postoperative period (3.3%): five gastric leaks (2.3%) and two major bleedings (0.9%). There was no postoperative mortality in the 209 patients. Long-term major complications occurred in 2 patients (0.9%). Median follow-up was 49.2 months (range, 2-72 months). Median postoperative BMI was 29.6 kg/m (range, 22-42 kg/m). Median %excess weight loss (%EWL) at 1 year after surgery was 52.0%. Median %EWL at last follow-up visit was 64.0%. LBSG is as safe as standard LSG with excellent results in terms of postoperative morbidity and weight loss outcomes. Whether this procedure may result superior to standard LSG in the long-term period needs to be evaluated in randomized trials. Clinical Study Registration Number: NCT04354532.

摘要

腹腔镜袖状胃切除术(LSG)现已成为治疗病态肥胖患者最常用的减重手术。LSG 的主要关注点在于长期体重反弹,据报道,6 年后多达 75.6%的患者会出现这种情况。在这项研究中,我们报告了在过去 6 年中使用 MiniMizer 进行腹腔镜带袖套胃切除术(LBSG)的总体经验。我们对前瞻性收集的数据库中的数据进行了回顾性分析。所有接受原发性 LBSG 的患者均接受了检查。患者于 2014 年 2 月至 2020 年 1 月期间接受 LBSG。收集的数据包括人口统计学因素、术前体重指数(BMI)、手术时间、手术并发症和临床结果。研究期间共有 209 例患者接受了原发性 LBSG。其中 136 例为女性(65%),73 例为男性(35%),中位年龄为 43.0 岁(范围 18-65 岁)。中位术前 BMI 为 48.4kg/m(范围 36.2-65.5kg/m)。中位手术时间为 72.0 分钟(范围 40-142 分钟)。中位环放置时间为 8.0 分钟。中位术后住院时间为 2.8 天。7 例患者在术后出现重大并发症(3.3%):5 例胃漏(2.3%)和 2 例大出血(0.9%)。209 例患者中无术后死亡。2 例患者出现长期重大并发症(0.9%)。中位随访时间为 49.2 个月(范围 2-72 个月)。中位术后 BMI 为 29.6kg/m(范围 22-42kg/m)。术后 1 年的中位体重减轻百分比(%EWL)为 52.0%。末次随访时的中位%EWL 为 64.0%。LBSG 与标准 LSG 一样安全,在术后发病率和减重效果方面均取得了优异的结果。该手术在长期内是否优于标准 LSG,需要在随机试验中进行评估。临床研究注册号:NCT04354532。

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