Department of General, Visceral- and Transplantation Surgery, RWTH Aachen University Hospital, Pauwelsstr. 30, 52074, Aachen, Germany.
Department of Gastroenterology, Digestive Diseases and Intensive Care Medicine, RWTH Aachen University Hospital, Pauwelsstr. 30, 52074, Aachen, Germany.
Surg Endosc. 2022 Jun;36(6):4401-4407. doi: 10.1007/s00464-021-08790-7. Epub 2021 Oct 26.
Bariatric surgery in super-super-obese (SSO) patients remains a continuous challenge due to intraabdominal fat masses, higher liver volume and existing comorbidities. A convenient procedure in SSO patients is one anastomosis gastric bypass (OAGB). The aim of this study was to compare the outcome of SSO patients undergoing OAGB in comparison to laparoscopic sleeve gastrectomy (LSG).
We retrospectively reviewed data from SSO patients who underwent OAGB and LSG in our institution between 2008 and 2020. Primary endpoints included percentage total body weight loss and percentage BMI loss at 12, 24, and 36 months after the operation. Secondary endpoints were perioperative complications, procedure length, length of hospital stay and outcome of comorbidities.
243 patients were included in this study. 93 patients underwent LSG and 150 underwent OAGB. At any of the time points evaluated, weight loss in patients after OAGB was greater than in LSG patients, while procedure length was significantly shorter for OAGB than LSG (81.4 vs. 92.1 min, p-value < 0.001). Additionally, mean length of hospital stay was shorter in the OAGB group (3.4 vs. 4.5 days, p-value < 0.001). There were more severe complications (Clavien-Dindo ≥ 3a) in the LSG group (11.8% vs 2.7%, p-value = 0.005).
In this retrospective analysis, OAGB was superior to LSG in terms of weight loss in SSO patients. Procedure length and hospital stay were shorter after OAGB in comparison to LSG and there were fewer severe complications. OAGB can therefore be regarded a safe and effective treatment modality for SSO patients.
由于内脏脂肪堆积、肝脏体积较大和存在合并症，超级肥胖（SSO）患者的减重手术仍然是一个持续的挑战。对于 SSO 患者来说，一种方便的手术方法是单吻合口胃旁路术（OAGB）。本研究旨在比较 OAGB 与腹腔镜袖状胃切除术（LSG）治疗 SSO 患者的结果。
我们回顾性分析了 2008 年至 2020 年期间在我院接受 OAGB 和 LSG 的 SSO 患者的数据。主要终点包括术后 12、24 和 36 个月时的总体重减轻百分比和 BMI 减轻百分比。次要终点是围手术期并发症、手术时间、住院时间和合并症的结果。
本研究共纳入 243 例患者。93 例患者行 LSG，150 例行 OAGB。在评估的任何时间点，OAGB 组患者的体重减轻均大于 LSG 组，而 OAGB 组的手术时间明显短于 LSG 组（81.4 分钟比 92.1 分钟，p 值<0.001）。此外，OAGB 组的平均住院时间较短（3.4 天比 4.5 天，p 值<0.001）。LSG 组的严重并发症（Clavien-Dindo≥3a）更多（11.8%比 2.7%，p 值=0.005）。
在这项回顾性分析中，OAGB 在 SSO 患者的体重减轻方面优于 LSG。与 LSG 相比，OAGB 的手术时间和住院时间更短，严重并发症更少。因此，OAGB 可被视为治疗 SSO 患者的一种安全有效的治疗方法。
