Dipartimento di Scienze Cliniche Applicate e Biotecnologie, Ospedale Civile San Salvatore, University of L'Aquila, L'Aquila, Italy.
Eur Rev Med Pharmacol Sci. 2021 Dec;25(23):7204-7210. doi: 10.26355/eurrev_202112_27412.
The role of antral resection (AR) in laparoscopic sleeve gastrectomy (LSG) is still a greatly debated topic in the literature. The aim of this study was to evaluate the results and complications of AR in LSG.
In this observational comparative study, 101 patients who underwent LSG were divided into two groups based on the extent of antral resection: 1 cm from the pylorus (1-DP group), or 6 cm from the pylorus (6-DP group). The %EWL (%Excess weight loss), resolution of T2D (Type 2 Diabetes Mellitus) and GLP-1 were investigated 48 hours before surgery and 3, 6 and 12 months after LSG. Postoperative complications in the first 30 days after surgery were also compared between the two groups using the Clavien-Dindo (CD) score.
A significant difference in %EWL was observed at 3 and 6 months in favor of the 1-DP group (38.9% and 57.8%, respectively) compared to the 6-DP group (31.4% and 49.7%, respectively). No difference in T2D resolution was observed between two groups during the follow-up period, with similar changes in GLP-1. Statistically significant differences were found between 1-DP and 6-DP group for the reintervention rate (CD III, 7.7% and 1.9%, respectively; p = 0.02) and life-threatening complications requiring intensive care unit management (CD IV, 3.8% and 0%, respectively, p = 0.03).
In LSG, sparing the antrum is associated with a significant reduction in the rate of postoperative complications, but the metabolic and weight results are comparable to those for antrum resection.
在腹腔镜袖状胃切除术（LSG）中，胃窦切除术（AR）的作用仍然是文献中一个极具争议的话题。本研究旨在评估 AR 在 LSG 中的结果和并发症。
在这项观察性对比研究中，根据胃窦切除范围，将 101 例接受 LSG 的患者分为两组：距幽门 1cm（1-DP 组）或距幽门 6cm（6-DP 组）。在手术前 48 小时、LSG 后 3、6 和 12 个月，调查 %EWL（超重减轻百分比）、T2D（2 型糖尿病）的缓解率和 GLP-1。还使用 Clavien-Dindo（CD）评分比较两组患者术后 30 天内的术后并发症。
在 3 个月和 6 个月时，1-DP 组的 %EWL 显著优于 6-DP 组（分别为 38.9%和 57.8%）。在随访期间，两组 T2D 缓解率无差异，GLP-1 也有类似变化。1-DP 组与 6-DP 组的再干预率（CD III，分别为 7.7%和 1.9%；p = 0.02）和需要重症监护病房管理的危及生命的并发症（CD IV，分别为 3.8%和 0%；p = 0.03）存在统计学显著差异。
在 LSG 中，保留窦部与术后并发症发生率显著降低相关，但代谢和减重效果与窦部切除相当。
