胃旁路术后总肠袢长度的作用：系统评价。
The role of total alimentary limb length in Roux-en-Y gastric bypass: a systematic review.
机构信息
Atrium Health Weight Management, Section of Bariatric & Metabolic Surgery, Department of Surgery, Carolinas Medical Center, Atrium Health, Charlotte, North Carolina.
Division of Research, Department of Surgery, Carolinas Medical Center, Atrium Health, Charlotte, North Carolina.
出版信息
Surg Obes Relat Dis. 2022 Apr;18(4):555-563. doi: 10.1016/j.soard.2021.08.022. Epub 2021 Aug 30.
BACKGROUND
Roux-en-Y gastric bypass (RYGB) is an established surgical treatment for obesity. Variations in limb length during RYGB procedures have been investigated for optimizing weight loss while minimizing nutritional deficiencies. The role of the total alimentary limb length (TALL; Roux limb plus common channel [CC]), however, is poorly defined.
OBJECTIVE
Compare TALL in RYGB procedures for weight loss outcomes and malnutrition.
SETTING
Systematic review.
METHODS
Ovid Medline and PubMed databases were searched for entries between 1993 and 2020. Search terms included "gastric bypass" and "TALL." Two independent reviewers screened the results.
RESULTS
A total of 21 studies measured TALL in RYGB. Of these, 4 of 6 reported a relationship between TALL and weight loss. Additionally, 11 studies reported that when TALL was ≤400 cm and CC <200 cm, 3.4% to 63.6% of patients required limb lengthening for protein malnutrition.
CONCLUSIONS
The majority of studies on RYGB do not report TALL length. There is some evidence that weight loss is affected by shortening TALL, while a TALL ≤400 cm with CC<200 should be avoided due to severe protein malnutrition. More studies on the effect of TALL are needed.
背景
Roux-en-Y 胃旁路术（RYGB）是治疗肥胖症的一种成熟的手术方法。在 RYGB 手术中，人们研究了不同的肢体长度变化，以优化减重效果，同时最大限度地减少营养缺乏。然而，总肠袢长度（TALL；Roux 肠袢加共同通道[CC]）的作用尚未明确。
目的
比较 RYGB 手术中 TALL 与减重效果和营养不良的关系。
设置
系统评价。
方法
在 1993 年至 2020 年期间，在 Ovid Medline 和 PubMed 数据库中检索相关条目。检索词包括“胃旁路”和“TALL”。两名独立的评审员筛选结果。
结果
共有 21 项研究测量了 RYGB 中的 TALL。其中，6 项研究中的 4 项报告了 TALL 与减重之间的关系。此外，11 项研究报告称，当 TALL≤400cm 且 CC<200cm 时，3.4%至 63.6%的患者需要进行肢体延长以治疗蛋白质营养不良。
结论
大多数关于 RYGB 的研究并未报告 TALL 长度。有一些证据表明，TALL 缩短会影响减重效果，而 TALL≤400cm 且 CC<200cm 时应避免发生严重的蛋白质营养不良。需要进一步研究 TALL 的影响。
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