Roux-en-Y胃旁路术与袖状胃切除术对BMI>35kg/m²的患者术后1年身体成分的影响。

Effects of Roux-en-Y Gastric Bypass Versus Sleeve Gastrectomy on Body Composition for Patients with a BMI > 35 kg/m at 1 Year After Surgery.

作者信息

Cui Beibei, Zhu Liyong, Zhu Shaihong

机构信息

Department of General Surgery, Central South University, The Third Xiangya Hospital, Changsha, 410013, Hunan, China.

出版信息

Obes Surg. 2022 May;32(5):1658-1666. doi: 10.1007/s11695-022-06006-y. Epub 2022 Mar 16.

DOI:10.1007/s11695-022-06006-y

PMID:35294693

Abstract

PURPOSE

Effects of Roux-en-Y gastric bypass (RYGB) versus sleeve gastrectomy (SG) on body composition have not been well compared. This meta-analysis aimed to compare changes in fat mass (FM) and lean tissue mass (LTM) for patients with a BMI > 35 kg/m at 1 year after RYGB and SG.

METHODS

PubMed, EMBASE, the Cochrane Library, and ClinicalTrials.gov were searched ending in December 2021 for eligible studies which reported baseline and postsurgical BMI, FM, and LTM.

RESULTS

Of 17 eligible studies, 831 patients were included, 484 following RYGB and 347 following SG. Weighted mean differences (WMD) and 95% confidence intervals (CI) were from a random-effects model. For patients with a BMI > 35 kg/m, RYGB resulted in a more substantial reduction of BMI (- 14.13 kg/m [95%CI - 14.74, - 13.53] versus - 11.96 kg/m [95%CI - 12.81, - 11.11], P < 0.001) and FM (- 26.22 kg [95%CI - 28.31, - 24.12] versus - 21.50 kg [95%CI - 25.52, - 17.48], P = 0.042) than SG, and a relatively weaker impact on LTM (- 8.28 kg [95%CI - 9.33, - 7.22] versus - 10.12 kg [95%CI - 11.55, - 8.68], P = 0.043).

CONCLUSION

This meta-analysis study indicates that RYGB is superior to SG in reducing excess FM for patients with a BMI > 35 kg/m and seems to be more beneficial when LTM preservation is taken into consideration.

摘要

目的

Roux-en-Y胃旁路术（RYGB）与袖状胃切除术（SG）对身体成分的影响尚未得到充分比较。本荟萃分析旨在比较RYGB和SG术后1年时体重指数（BMI）>35kg/m²的患者的脂肪量（FM）和瘦组织量（LTM）的变化。

方法

检索截至2021年12月的PubMed、EMBASE、Cochrane图书馆和ClinicalTrials.gov，查找报告了基线和术后BMI、FM和LTM的合格研究。

结果

在17项合格研究中，纳入了831例患者，其中484例行RYGB，347例行SG。加权平均差（WMD）和95%置信区间（CI）来自随机效应模型。对于BMI>35kg/m²的患者，RYGB导致BMI的降低幅度更大（-14.13kg/m²[95%CI -14.74，-13.53] vs -11.96kg/m²[95%CI -12.81，-11.11]，P<0.001），FM降低幅度更大（-26.22kg[95%CI -28.31，-24.12] vs -21.50kg[95%CI -25.52，-17.48]，P = 0.042），而对LTM的影响相对较小（-8.28kg[95%CI -9.33，-7.22] vs -10.12kg[95%CI -11.55，-8.68]，P = 0.043）。