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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.

Abstract

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.

摘要

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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本文引用的文献

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Hair Loss After Sleeve Gastrectomy and Effect of Biotin Supplements.袖状胃切除术后的脱发及生物素补充的影响。
J Laparoendosc Adv Surg Tech A. 2021 Mar;31(3):296-300. doi: 10.1089/lap.2020.0468. Epub 2020 Aug 5.
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Bariatric Surgery Worldwide 2013.《2013年全球减肥手术》
Obes Surg. 2015 Oct;25(10):1822-32. doi: 10.1007/s11695-015-1657-z.
10
Effect of preoperative weight loss in bariatric surgical patients: a systematic review.减重手术患者术前体重减轻的效果:系统评价。
Surg Obes Relat Dis. 2011 Nov-Dec;7(6):760-7; discussion 767. doi: 10.1016/j.soard.2011.08.011. Epub 2011 Aug 27.

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