Department of General Surgery, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Department of General Surgery, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
Obes Surg. 2022 Jun;32(6):1918-1925. doi: 10.1007/s11695-022-05958-5. Epub 2022 Feb 24.
Patients with mild obesity especially in absence of associated medical problems (OAMP) are commonly managed by non-surgical approaches. Laparoscopic sleeve gastrectomy (LSG) has proved itself to be effective and it is now the most performed weight loss procedure. We aimed to study the effectiveness and safety of LSG for weight loss in mild obesity.
A prospective cohort study. Group A; BMI (30-34.9 kg/m), and group B; BMI ≥ 40 or BMI ≥ 35 with OAMP. Demographic data, perioperative complications, % excess weight loss (EWL), % total weight loss (TWL), nutritional profile, and evolution of OAMP were recorded and statistically analyzed.
A total of 250 patients, with 80 patients (32%) in group A, and 170 (68%) in group B. The majority were female. The mean preoperative weight, BMI, and excess weight were 90.1 ± 9.52, 32.7 ± 1.4, and 21.5 ± 4.9 in group A, and 129.88 ± 26.12, 47.8 ± 8.2, and 62.3 ± 23.6 kg in group B respectively. The low BMI group had significantly lower OAMP, with higher pre-LSG non-surgical procedures rate. Overall post-operative morbidity rate was significantly higher in group B. %TWL was significantly lower in low BMI group. Nutritional profile was within the normal range in both groups at 3-year follow-up.
Laparoscopic sleeve gastrectomy is a safe and effective weight loss solution for mild obesity with better outcome than for higher BMI. Further studies are warranted to reconsider NIH's statement for medicolegal aspects, and for matching the current changes in bariatric surgery practice, safety evidence, and patients' demand.
对于没有相关医疗问题（OAMP）的轻度肥胖患者，通常采用非手术方法进行治疗。腹腔镜袖状胃切除术（LSG）已被证明是有效的，并且现在是最常进行的减肥手术。我们旨在研究 LSG 在轻度肥胖减肥中的有效性和安全性。
前瞻性队列研究。A 组：BMI（30-34.9kg/m），B 组：BMI≥40 或 BMI≥35 且伴有 OAMP。记录并统计分析人口统计学数据、围手术期并发症、超重减轻百分比（EWL）、总体体重减轻百分比（TWL）、营养状况和 OAMP 的演变。
共 250 例患者，其中 A 组 80 例（32%），B 组 170 例（68%）。大多数为女性。A 组术前体重、BMI 和超重分别为 90.1±9.52kg、32.7±1.4kg 和 21.5±4.9kg，B 组分别为 129.88±26.12kg、47.8±8.2kg 和 62.3±23.6kg。低 BMI 组 OAMP 显著降低，术前非手术治疗率较高。B 组术后总发病率显著较高。低 BMI 组的 TWL 显著较低。两组患者在 3 年随访时的营养状况均在正常范围内。
腹腔镜袖状胃切除术是治疗轻度肥胖的一种安全有效的减肥方法，其效果优于 BMI 较高的患者。需要进一步研究来重新考虑 NIH 关于医疗法律方面的声明，并根据当前减重手术实践、安全性证据和患者需求的变化进行调整。
