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与 Roux-en-y 胃旁路术(RYGB)相比,单吻合口胃旁路术(OAGB)后人体测量指标、营养指数及胃肠道症状的变化。

Changes in Anthropometric Measures, Nutritional Indices and Gastrointestinal Symptoms Following One Anastomosis Gastric Bypass (OAGB) Compared with Roux-en-y Gastric Bypass (RYGB).

作者信息

Zarshenas Nazy, Tapsell Linda Clare, Batterham Marijka, Neale Elizabeth Phillipa, Talbot Michael Leonard

机构信息

School of Medicine, Faculty of Science Medicine and Health, University of Wollongong, Wollongong, NSW, Australia.

Shore Surgical, Suite 204, Level 2/156 Pacific Highway, Greenwich, NSW, 2065, Australia.

出版信息

Obes Surg. 2021 Jun;31(6):2619-2631. doi: 10.1007/s11695-021-05284-2. Epub 2021 Feb 23.

Abstract

PURPOSE

Bariatric surgery is an effective treatment for obesity with new procedures emerging. However, despite comparable weight loss and improvements in metabolic outcomes, research on nutritional and gastrointestinal symptoms remains limited. Here we compare clinical data on weight, nutritional disorders and gastrointestinal symptoms of patients before and following one anastomosis gastric bypass (OAGB) and Roux-en-Y gastric Bypass (RYGB).

MATERIALS AND METHODS

In this retrospective study, data on anthropometry, nutritional indices, dietary intake and gastrointestinal symptoms were retrieved in cohorts of patients up to 2 years following OAGB and RYGB.

RESULTS

Seventy-three patients had either a RYGB (28) or an OAGB (45), with 71% seeking these as a revisional procedure. Significant and higher weight loss was observed in the OAGB cohort at 1 year (%TWL 33.0 ± 8.5 vs. 26.6 ± 12.4), albeit comparable at 2 years postoperatively (%TWL 29.0 ± 11.1 vs. 34.1 ± 11.2). Disorders such as vitamin D, active B12, folate, homocystein (Hcy) and hyperparathyroidism were present following both surgeries. Levels of vitamin D, ferritin and total protein significantly worsened over time. Gastrointestinal symptoms of diarrhoea, steatorrhoea and reflux were higher in the OAGB cohort while the RYGB cohort reported more dumping syndrome (DS).

CONCLUSION

Significant and similar weight loss results are seen following both OAGB and RYGB. Nutritional disorders were common in both cohorts and increased over time. However, the OAGB patients reported more gastrointestinal side effects, which may contribute to poor quality of life and nutritional consequences. Prospective and longer-term studies investigating the nutritional and gastrointestinal health of patients undergoing OAGB is recommended.

摘要

目的

减肥手术是治疗肥胖症的有效方法,新的手术方式不断涌现。然而,尽管在体重减轻和代谢指标改善方面相当,但关于营养和胃肠道症状的研究仍然有限。在此,我们比较了单吻合口胃旁路术(OAGB)和Roux-en-Y胃旁路术(RYGB)患者术前和术后的体重、营养障碍及胃肠道症状的临床数据。

材料与方法

在这项回顾性研究中,收集了接受OAGB和RYGB手术长达2年的患者队列中的人体测量学、营养指标、饮食摄入及胃肠道症状数据。

结果

73例患者接受了RYGB(28例)或OAGB(45例)手术,其中71%将其作为修正手术。OAGB组在1年时体重减轻更为显著(%TWL 33.0±8.5 vs. 26.6±12.4),尽管术后2年时两组相当(%TWL 29.0±11.1 vs. 34.1±11.2)。两种手术后均出现维生素D、活性维生素B12、叶酸、同型半胱氨酸(Hcy)及甲状旁腺功能亢进等紊乱。维生素D、铁蛋白和总蛋白水平随时间显著恶化。OAGB组的腹泻、脂肪泻和反流等胃肠道症状较多,而RYGB组报告的倾倒综合征(DS)更多。

结论

OAGB和RYGB术后体重减轻效果显著且相似。两组营养障碍均常见且随时间增加。然而,OAGB患者报告的胃肠道副作用更多,这可能导致生活质量下降和营养问题。建议开展前瞻性长期研究,以调查接受OAGB手术患者的营养和胃肠道健康状况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/afa8/7901677/44b502ed3a24/11695_2021_5284_Fig1_HTML.jpg

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