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肾移植后腹腔镜袖状胃切除术对合并症、移植肾功能及生活质量的可行性和影响

Feasibility and impact of laparoscopic sleeve gastrectomy after renal transplantation on comorbidities, graft function and quality of life.

作者信息

AlEnazi Naif A, Ahmad Khaled S, Elsamahy Ilham A, Essa Mohamed S

机构信息

Department of General Surgery, Ad Diriyah Hospital, Ar Rihab, Riyadh, Saudi Arabia.

Department of Anesthesia, Islamic Center for Heart Diseases and Cardiac Surgeries, Faculty of Medicine, El-Azhar University, Cairo, Egypt.

出版信息

BMC Surg. 2021 May 4;21(1):235. doi: 10.1186/s12893-021-01138-x.

Abstract

BACKGROUND

The aim of this study is to clarify the feasibility and effect of laparoscopic sleeve gastrectomy (LSG) on comorbidities, graft function and quality of life in patients who underwent renal transplantation (RT).

METHODS

This is a retrospective review of five patients who underwent LSG after RT. Demographic data, anthropometric parameters, the effect on comorbidities, postoperative course, immunosuppressive medications, causes of RT, renal function, the survival of graft, and quality of life after SG in obese patients with a history of RT were assessed using BAROS-Moorhead-Ardelt survey RESULTS: From September 2015 to September 2019, 5 renal transplant patients underwent LSG; three female, and two male. Median body mass index (BMI) decreased from 42.17 kg/m (range 36-55) before surgery to 28.16 kg/m (range 25-42) after surgery. Improvement in blood pressure, triglyceride, and cholesterol levels was observed, and all cases were able to decrease their medications. Insulin was stopped and replaced with linagliptin in all diabetic patients. Graft function improved, and proteinuria level decreased in all cases. All patients reported to have an excellent quality of life.

CONCLUSION

LSG showed excellent outcomes in this high-risk group of patients regarding comorbidities, graft function and quality of life.

摘要

背景

本研究旨在阐明腹腔镜袖状胃切除术(LSG)对肾移植(RT)患者合并症、移植肾功能及生活质量的可行性和效果。

方法

这是一项对5例肾移植后接受LSG患者的回顾性研究。使用BAROS - Moorhead - Ardelt调查评估了肥胖肾移植患者的人口统计学数据、人体测量参数、对合并症的影响、术后病程、免疫抑制药物、肾移植原因、肾功能、移植肾存活情况以及胃切除术后的生活质量。

结果

2015年9月至2019年9月,5例肾移植患者接受了LSG;3例女性,2例男性。术前中位体重指数(BMI)从42.17kg/m²(范围36 - 55)降至术后的28.16kg/m²(范围25 - 42)。观察到血压、甘油三酯和胆固醇水平有所改善,所有病例的药物用量均减少。所有糖尿病患者停用胰岛素,改用利格列汀。所有病例的移植肾功能均有改善,蛋白尿水平降低。所有患者均报告生活质量极佳。

结论

对于这一高危患者群体,LSG在合并症、移植肾功能和生活质量方面显示出极佳的效果。

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