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袖状胃切除术、Roux-en-Y胃旁路术和单吻合口胃旁路术后倾倒综合征的发生率。

Incidence of Dumping Syndrome after Sleeve Gastrectomy, Roux-en-Y Gastric Bypass and One-Anastomosis Gastric Bypass.

作者信息

Poljo Adisa, Pentsch Andreas, Raab Sandra, Klugsberger Bettina, Shamiyeh Andreas

机构信息

Clinic for General and Visceral Surgery, Kepler University Clinic, Linz, Austria.

Faculty of Medicine, Johannes Kepler University, Linz, Austria.

出版信息

J Metab Bariatr Surg. 2021 Jun;10(1):23-31. doi: 10.17476/jmbs.2021.10.1.23. Epub 2021 Jun 30.

Abstract

PURPOSE

Dumping syndrome (DS) is an important but often underreported problem occurring after bariatric surgery. It is believed that gastric bypass procedures like Roux-en-Y Gastric By-pass (RYGB) and One-Anastomosis Gastric Bypass (OAGB) are more likely to cause DS than the pylorus-preserving Sleeve Gastrectomy (SG). The aim of this study was to evaluate the incidence of DS in patients undergoing SG, RYGB and OAGB.

MATERIALS AND METHODS

A retrospective clinical study with 180 patients undergoing SG (n=50), RYGB (n=53) and OAGB (n=77) between 2016-2018 was performed. All clinical and demo-graphic data were assessed. The percentage of excess weight loss (%EWL) was used to evaluate weight reduction. 127/180 (70.6%) patients took part in an additional phone interview. The incidence of DS was evaluated using validated Sigstad Score.

RESULTS

Information about the occurrence of dumping symptoms and patient satisfaction was obtained from 127 patients. Median follow-up was 20.0±11.4 months. Significant differences between the surgical procedures were found for the duration of surgery, complications, weight loss, incidence of DS and satisfaction postoperatively. DS occurred in 15.6% after SG, 56.4% after RYGB and 42.9% after OAGB. A higher weight loss was observed in patients who experienced dumping symptoms.

CONCLUSION

The present results show a clear superiority of SG regarding both perioperative results and incidence of DS compared to RYGB and OAGB and may impact clinicians and patients in their choice of procedure.

摘要

目的

倾倒综合征(DS)是减重手术后出现的一个重要但常被漏报的问题。人们认为,诸如Roux-en-Y胃旁路术(RYGB)和单吻合口胃旁路术(OAGB)等胃旁路手术比保留幽门的袖状胃切除术(SG)更易引发DS。本研究旨在评估接受SG、RYGB和OAGB手术患者的DS发生率。

材料与方法

对2016年至2018年间180例接受SG(n = 50)、RYGB(n = 53)和OAGB(n = 77)手术的患者进行了一项回顾性临床研究。评估了所有临床和人口统计学数据。采用超重体重减轻百分比(%EWL)评估体重减轻情况。127/180(70.6%)例患者参与了额外的电话访谈。使用经过验证的Sigstad评分评估DS的发生率。

结果

从127例患者中获取了倾倒症状发生情况及患者满意度的信息。中位随访时间为20.0±11.4个月。发现手术方式在手术时长、并发症、体重减轻、DS发生率及术后满意度方面存在显著差异。SG术后DS发生率为15.6%,RYGB术后为56.4%,OAGB术后为42.9%。出现倾倒症状的患者体重减轻更明显。

结论

目前的结果显示,与RYGB和OAGB相比,SG在围手术期结果和DS发生率方面均具有明显优势,这可能会影响临床医生和患者在手术方式上的选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/12db/9847648/6d7e6be6dcf3/jmbs-10-23-g001.jpg

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