Department of Surgery, Medical Research Institute, Alexandria University, 165 Horreya Avenue, Hadara, Alexandria, 21561, Egypt.
Consultant of Bariatric Surgery at Madina Women's Hospital (IFSO Center of Excellence), Alexandria, Egypt.
Obes Surg. 2023 Feb;33(2):406-417. doi: 10.1007/s11695-022-06404-2. Epub 2022 Dec 12.
Sleeve dilatation after laparoscopic sleeve gastrectomy (LSG) causes weight regain (WR). Banded sleeve gastrectomy (BSG) was proposed to prevent dilatation and reduce WR.
A retrospective cohort study on patients who underwent BSG and LSG and completed 4 years of follow-up from 2016 to 2021 was included. Body mass index (BMI), percentage of excess weight loss (%EWL), percentage of total weight loss (%TWL), and FT scores were calculated at 1, 2, 3, and 4 years. The sleeve volume was estimated at 6 months, 1 year, and 4 years. Multi-variate analysis was conducted to assess correlations between covariates. WR was calculated as weight gain > 10%, > 10 kg above the nadir, or BMI increase of ≥ 5 kg/m 2 above the nadir.
This study included LSG 1279 patients and BSG 132 patients. Mean %EWL at 1 year was 83.87 ± 17.25% in LSG vs. 85.71 ± 7.92% in BSG and was 83.47 ± 18.87% in LSG and 85.54 ± 7.48% in BSG at 4 years. Both had significant weight loss over time (p. < 0.001) with no significant main effect of surgery (p.0.438). Mean sleeve volume at 6 months was 102.32 ± 9.88 ± 10.28 ml in LSG vs. 101.89 ± 10.019 ml in BSG and at 4 years was 580.25 ± 112.25 ml in LSG vs. 157.94 ± 12.54 ml in BSG (p. < 0.001). WR occurred in 136 (10.6%) and 4 (3.1%) (p.0.002) in LSG and BSG patients, 90 (7%) vs. zero (0%) (p.0.002) and 31 (2.4%) vs. zero (0%) (p.0.07) using the > 10%, > 10 kg increase above the nadir and the ≥ 5 kg/m 2 BMI increases above the nadir formulas, respectively.
BSG had significantly lower sleeve volume, significantly lower WR, and significantly lower FT scores than LSG after 4 years from surgery; however, volume changes were not correlated with weight loss.
腹腔镜袖状胃切除术（LSG）后袖套扩张会导致体重反弹（WR）。带囊袖状胃切除术（BSG）的提出是为了防止扩张并减少 WR。
这是一项回顾性队列研究，纳入了 2016 年至 2021 年期间接受 BSG 和 LSG 并完成 4 年随访的患者。在 1、2、3 和 4 年时计算体重指数（BMI）、体重减轻百分比（%EWL）、总体重减轻百分比（%TWL）和 FT 评分。在 6 个月、1 年和 4 年时估计袖套容积。采用多变量分析评估协变量之间的相关性。WR 定义为体重增加>10%、体重增加>10kg 超过最低点或 BMI 增加≥5kg/m 2 超过最低点。
本研究纳入了 1279 例 LSG 患者和 132 例 BSG 患者。LSG 组 1 年时的平均%EWL 为 83.87±17.25%，BSG 组为 85.71±7.92%，4 年时分别为 83.47±18.87%和 85.54±7.48%。两组患者在整个研究过程中体重均持续减轻（p<0.001），但手术对体重减轻无显著主要影响（p.0.438）。LSG 组在 6 个月时的平均袖套容积为 102.32±9.88±10.28ml，BSG 组为 101.89±10.019ml，4 年后 LSG 组为 580.25±112.25ml，BSG 组为 157.94±12.54ml（p<0.001）。LSG 和 BSG 患者中分别有 136 例（10.6%）和 4 例（3.1%）发生 WR（p<0.001），90 例（7%）和 0 例（0%）使用>10%、>10kg 超过最低点和≥5kg/m 2 BMI 增加超过最低点公式，31 例（2.4%）和 0 例（0%）（p.0.07）。
BSG 在术后 4 年时袖套体积明显小于 LSG，WR 和 FT 评分明显低于 LSG，但体积变化与体重减轻无关。
