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腹腔镜胃折叠术治疗病态肥胖的长期疗效:单中心经验。

Long-Term Outcomes of Laparoscopic Gastric Plication for Treatment of Morbid Obesity: a Single-Center Experience.

机构信息

Faculty of Medicine, Mansoura University, Mansoura, Egypt.

Department of General Surgery, Faculty of Medicine, Gastrointestinal Surgical Center GISC, Mansoura University, Al Dakahlia Governorate, Gehan Street, Mansoura, 35511, Egypt.

出版信息

Obes Surg. 2022 Oct;32(10):3324-3331. doi: 10.1007/s11695-022-06217-3. Epub 2022 Aug 12.

Abstract

BACKGROUND

Although laparoscopic gastric plication (LGP) has been mentioned in many studies, its practice has not yet been standardized. In addition, the outcomes remain conflicting, especially long-term ones. This study was conducted to elucidate the long-term consequences of LGP.

METHODS

Retrospective analysis of patients with obesity underwent LGP at our institution between March 2010 and September 2014. Data were prospectively collected from our database.

RESULTS

Of the 88 consecutive patients in the study period between 2010 and 2014, follow-up data out to 6 years was available in 60 LGP patients (68.18%). The mean age of the included patients was 41.3 ± 10 years. A total of 81.7% were females. We observed a significant BMI reduction out to 2 years (p < 0.001), a plateau at 3 and 4 years, and a significant BMI increase at 6 years (p < 0.01). %TWL at 2 years was 21.14% and 12.08% at 6 years. Weight regain was observed in 35 patients at 6 years to reach a rate of 58.3%. Predictors for weight regain at 6 years were disrupted plication fold, increased hunger, and non-adherence to regular exercise. The diabetes improvement rate was 66.6% at 6 years. There were 14 re-operations (23.3%): 1 emergency (1.6%) and 13 (21.6%) elective. There was no mortality.

CONCLUSION

At the 6-year follow-up visit, LGP has a much less durable effect on weight loss with a % EWL of 32% and a weight regain of 58.3% resulting in a high rate of revisions.

摘要

背景

虽然腹腔镜胃折叠术(LGP)在许多研究中都有提及,但它的应用尚未标准化。此外,其结果仍存在争议,尤其是长期结果。本研究旨在阐明 LGP 的长期后果。

方法

对 2010 年 3 月至 2014 年 9 月在我院行 LGP 的肥胖患者进行回顾性分析。数据从我们的数据库中前瞻性收集。

结果

在 2010 年至 2014 年的研究期间,88 例连续患者中,有 60 例 LGP 患者(68.18%)可获得 6 年的随访数据。纳入患者的平均年龄为 41.3±10 岁,81.7%为女性。我们观察到,体重指数(BMI)在 2 年内显著降低(p<0.001),3 年和 4 年时达到平台期,6 年内 BMI 显著增加(p<0.01)。2 年内的体重减轻率(%TWL)为 21.14%,6 年内为 12.08%。6 年后有 35 例患者体重反弹,反弹率为 58.3%。6 年后体重反弹的预测因素为折叠处破坏、饥饿感增加和不规律运动。6 年后糖尿病改善率为 66.6%。共有 14 例再次手术(23.3%):1 例急诊(1.6%),13 例(21.6%)择期。无死亡病例。

结论

在 6 年随访时,LGP 对体重减轻的效果持续时间更短,体重减轻率(%EWL)为 32%,体重反弹率为 58.3%,导致修复率较高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c8a9/9532336/634135bb83ba/11695_2022_6217_Fig1_HTML.jpg

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