Department of Gastrointestinal Surgery, Laboratory of Bariatric and Metabolic Surgery, West China Hospital, Sichuan University, Chengdu, China.
Department of Gastrointestinal Surgery and Laboratory of Gastric Cancer, State Key Laboratory of Biotherapy, Collaborative Innovation Center for Biotherapy, West China Hospital, Sichuan University, Chengdu, China.
Obes Surg. 2021 Jul;31(7):3303-3311. doi: 10.1007/s11695-021-05456-0. Epub 2021 May 6.
Sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) are the most commonly performed bariatric procedures globally, but both techniques have shortcomings. Several modifications of SG (SG plus procedures) have been developed, but the efficacy of the different procedures has not been completely elucidated. In this meta-analysis, we aimed to evaluate the efficacy and safety of SG plus procedures. Out of the initially identified 2357 studies, thirteen were selected for this meta-analysis: two studies on banded sleeve gastrectomy (BSG), four studies on sleeve gastrectomy plus duodenal-jejunal bypass (SG + DJB) or sleeve gastrectomy with loop duodenal-jejunal bypass (SADJB), two studies on sleeve gastrectomy with jejunal-jejunal bypass (SG + JJB), four studies on single anastomosis duodenal-ileal switch (SADI-S), and one study on stomach intestinal pylorus-sparing surgery (SIPS). SADI-S procedure was found to achieve significantly greater percentage of excess weight loss than the RYGB. SG + DJB and SADJB achieved greater weight loss than the RYGB. Major complications were fewer with SG + JJB than with RYGB, but the difference was not significant. Overall, SG plus procedures appear to achieve better weight loss and cause fewer complications than RYGB.
袖状胃切除术（SG）和 Roux-en-Y 胃旁路术（RYGB）是全球最常施行的减重手术，但这两种技术都存在缺点。已经开发出几种 SG 的改良术式（SG 附加术式），但不同术式的疗效尚未完全阐明。在这项荟萃分析中，我们旨在评估 SG 附加术式的疗效和安全性。在最初确定的 2357 项研究中，有 13 项被纳入本荟萃分析：两项关于带囊袖状胃切除术（BSG）的研究，四项关于袖状胃切除术加十二指肠空肠旁路术（SG+DJB）或袖状胃切除术加Loop 十二指肠空肠旁路术（SADJB）的研究，两项关于袖状胃切除术加空肠空肠旁路术（SG+JJB）的研究，四项关于单吻合口十二指肠空肠旁路术（SADI-S）的研究，以及一项关于胃空肠保留幽门手术（SIPS）的研究。SADI-S 术式与 RYGB 相比，实现了显著更高的多余体重减轻百分比。SG+DJB 和 SADJB 比 RYGB 实现了更大的体重减轻。SG+JJB 比 RYGB 发生的主要并发症更少，但差异无统计学意义。总体而言，SG 附加术式似乎比 RYGB 实现了更好的减重效果，且引起的并发症更少。
