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一项前瞻性单中心研究,评估胃、肠和幽门保留术的疗效。

A prospective single-center study evaluating the efficacy of the stomach, intestinal, and pylorus-sparing procedure.

机构信息

Presbyterian Bariatric Center, Rio Rancho, New Mexico.

Presbyterian Bariatric Center, Rio Rancho, New Mexico.

出版信息

Surg Obes Relat Dis. 2023 Jun;19(6):612-618. doi: 10.1016/j.soard.2022.12.020. Epub 2022 Dec 12.

Abstract

BACKGROUND

The stomach, intestinal, and pylorus-sparing (SIPS) procedure is a single-anastomosis duodeno-intestinal bypass used in obesity management.

OBJECTIVE

Weight and metabolic outcomes in patients with severe obesity who underwent the SIPS procedure were evaluated in a community hospital-based study.

SETTING

Community hospital.

METHODS

This single-site prospective study of patients who underwent the SIPS procedure evaluated outcomes at 12 and 24 months. Mean changes in total weight loss and body mass index (BMI) and resolution of gastroesophageal reflux disease (GERD), obstructive sleep apnea (OSA), hypertension, type 2 diabetes (T2D), and hyperlipidemia were evaluated.

RESULTS

At baseline, 185 patients were enrolled; mean weight and BMI were 144.0 kg and 52.2 kg/m, respectively. Data for 88 (47.6%) and 29 (15.7%) patients who completed follow-up at 12 and 24 months, respectively, were available. At 12 months, mean total weight loss was 35.6% (weight reduction of 51.3 kg) and BMI reduction of 17.8 points were achieved and were maintained for the 29 patients who completed 24-month follow-up. No leaks or infections occurred. Complications occurred in 8 patients (.4%) and were not serious. Resolution of GERD, OSA, hypertension, T2D, and hyperlipidemia achieved in 87.1%, 59.2%, 32.7%, 93.1%, and 87.6% of patients, respectively, at 12 months was maintained at 24 months. Nutritional deficiency was absent.

CONCLUSIONS

Patients who underwent the SIPS procedure had meaningful reductions in weight and BMI, and many had resolution of metabolic co-morbidities; procedural complication rates were low. Our results support that the SIPS procedure is a safe and effective primary treatment for clinically severe obesity in a community-based hospital setting.

摘要

背景

胃、肠和幽门保留(SIPS)手术是一种用于肥胖管理的单吻合口十二指肠空肠旁路术。

目的

在社区医院基础研究中评估严重肥胖患者接受 SIPS 手术后的体重和代谢结果。

地点

社区医院。

方法

这项对接受 SIPS 手术的患者进行的单站点前瞻性研究评估了 12 个月和 24 个月的结果。评估总减重和体重指数(BMI)的平均变化以及胃食管反流病(GERD)、阻塞性睡眠呼吸暂停(OSA)、高血压、2 型糖尿病(T2D)和高脂血症的缓解情况。

结果

在基线时,185 名患者入组;平均体重和 BMI 分别为 144.0 公斤和 52.2 公斤/米。分别有 88(47.6%)和 29(15.7%)名完成 12 个月和 24 个月随访的患者有数据。在 12 个月时,平均总减重为 35.6%(体重减轻 51.3 公斤),BMI 降低 17.8 个点,并在完成 24 个月随访的 29 名患者中维持。没有发生泄漏或感染。8 名患者(0.4%)发生了并发症,但不严重。在 12 个月时,分别有 87.1%、59.2%、32.7%、93.1%和 87.6%的患者 GERD、OSA、高血压、T2D 和高脂血症得到缓解,在 24 个月时仍得到维持。不存在营养缺乏。

结论

接受 SIPS 手术的患者体重和 BMI 有明显减轻,许多患者代谢合并症得到缓解;手术并发症发生率低。我们的结果支持 SIPS 手术是社区医院环境中严重肥胖临床治疗的一种安全有效的主要治疗方法。

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