Department of Surgery, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, No. 42, Arabi St., Yemen St., Chamran Exp, Tehran, Iran.
Obes Surg. 2021 Jun;31(6):2489-2496. doi: 10.1007/s11695-021-05313-0. Epub 2021 Mar 8.
This cohort study was designed to compare the efficacy and safety of laparoscopic Roux-en-Y gastric bypass (LRYGB) and laparoscopic sleeve gastrectomy (LSG) for the management of morbid obesity during the 11-year experience.
This study was conducted between July 2006 and August 2019. Annually we recorded data about the weight, body mass index (BMI), percentage of excess weight loss (%EWL), percentage of weight loss (%WL), weight regain, and postoperative complications into a prospectively collected database.
A total of 1146 patients (LRYGB=396 and LSG=750) aged >18 years old were included in the study. Over the first 7 years after surgery, the weight loss rate was significantly higher in the LRYGB-treated group than the LSG-treated group, and weight regain was significantly lower in the LRYGB-treated group in comparison with the LSG-treated group. Our results revealed that statistically, but not clinically, the efficacy of LRYGB and LSG is equivalent in terms of %WL, %EWL, and weight regain within 8 years and more. Besides, there were no significant differences in surgery-related mortality and severe complications between the two procedures.
Our study's results indicated that the clinical efficacy of LRYGB in the management of obesity is better than LSG during the 11-year experience. But the differences in weight loss and weight regain were not statistically relevant at 8 years and more after the surgery. Also, a comparison of severe complications did not indicate significant differences between the two groups.
本队列研究旨在比较腹腔镜 Roux-en-Y 胃旁路术(LRYGB)和腹腔镜袖状胃切除术(LSG)在 11 年经验中治疗病态肥胖的疗效和安全性。
本研究于 2006 年 7 月至 2019 年 8 月进行。我们每年将体重、体重指数(BMI)、超重减轻百分比(%EWL)、体重减轻百分比(%WL)、体重反弹和术后并发症的数据记录到一个前瞻性收集的数据库中。
共有 1146 名年龄大于 18 岁的患者(LRYGB=396 例和 LSG=750 例)纳入本研究。手术后的前 7 年,LRYGB 治疗组的减重率明显高于 LSG 治疗组,而 LRYGB 治疗组的体重反弹率明显低于 LSG 治疗组。我们的结果表明,在 8 年及以上的时间内,LRYGB 和 LSG 在 %WL、%EWL 和体重反弹方面的疗效在统计学上但在临床上是等效的。此外,两种手术的手术相关死亡率和严重并发症之间没有显著差异。
我们的研究结果表明,在 11 年的经验中,LRYGB 在肥胖管理中的临床疗效优于 LSG。但在手术后 8 年及以上,体重减轻和体重反弹的差异在统计学上并不相关。此外,对严重并发症的比较也没有表明两组之间存在显著差异。