术前体重减轻对接受腹腔镜袖状胃切除术患者预后的影响。
Effect of pre-operative weight loss on patients' outcomes undergoing laparoscopic sleeve gastrectomy.
作者信息
Sen Ozan, Türkçapar Ahmet Gökhan
机构信息
Türkçapar Bariatrics, Obesity Center; Department of Health Sciences, Nişantaşı University, Istanbul, Turkey.
Türkçapar Bariatrics, Obesity Center, Istanbul, Turkey.
出版信息
J Minim Access Surg. 2022 Apr-Jun;18(2):260-263. doi: 10.4103/jmas.JMAS_297_20.
BACKGROUND
The study aims to demonstrate whether weight loss with a low-calorie diet before laparoscopic sleeve gastrectomy (LSG) may affect the outcomes.
MATERIALS AND METHODS
A total of 305 patients undergoing primary LSG were included in the study. Each patient adopted a low-calorie diet (1000 calories) before LSG. The patients were stratified into two groups. Group A: Those who lost 3% or more of their total body weight loss (TBWL), Group B: Those who lost <3% of their TBWL. Two groups were compared in terms of operative time, length of hospital stay, complications and weight loss outcomes.
RESULTS
One hundred and five patients (35%) were in Group A and 200 patients were in Group B. Median weight loss was 4 kg (3-20 kg). Pre-operative mean body mass index (BMI) was 40 ± 7.4 kg/m in Group A and 41 ± 5.9 kg/m in Group B (P = 0.06). At 1 year after the surgery, BMI regressed to 29.7 ± 4.9 kg/m in Group A and to 27 ± 4.2 kg/m in Group B (P < 0.001). One hundred and twenty-nine patients who completed 2 years of follow-up, mean BMI regressed to 29.4 ± 4.1 kg/m in Group A (n = 46) and to 27.2 ± 4.5 kg/m in Group B (n = 83) (P < 0.001). In Group B, one patient experienced post-operative bleeding. No other complications were observed in the study. There was no significant difference between the groups in terms of operative time (P = 0.53) and length of hospital stay (P = 0.9).
CONCLUSION
Weight loss before LSG does not improve post-operative weight loss.
背景
本研究旨在证明腹腔镜袖状胃切除术（LSG）前采用低热量饮食减肥是否会影响手术效果。
材料与方法
本研究共纳入305例行初次LSG的患者。每位患者在LSG前采用低热量饮食（1000卡路里）。患者被分为两组。A组：总体重减轻（TBWL）达3%或更多的患者；B组：TBWL减轻不足3%的患者。比较两组患者的手术时间、住院时间、并发症及减肥效果。
结果
A组有105例患者（35%），B组有200例患者。体重减轻中位数为4kg（3 - 20kg）。A组术前平均体重指数（BMI）为40±7.4kg/m²，B组为41±5.9kg/m²（P = 0.06）。术后1年，A组BMI降至29.7±4.9kg/m²，B组降至27±4.2kg/m²（P < 0.001）。129例完成2年随访的患者，A组（n = 46）平均BMI降至29.4±4.1kg/m²，B组（n = 83）降至27.2±4.5kg/m²（P < 0.001）。B组有1例患者术后出血。本研究未观察到其他并发症。两组在手术时间（P = 0.53）和住院时间（P = 0.9）方面无显著差异。
结论
LSG前减肥并不能改善术后减肥效果。
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