肥胖患者接受减重手术后的 12 个月结果：单中心经验。

Twelve-Month Outcomes in Patients with Obesity Following Bariatric Surgery-A Single Centre Experience.

机构信息

Department of Surgery I, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania.

3rd Surgical Unit, Department of Surgery, "St. Spiridon" County Clinical Emergency Hospital, 700111 Iasi, Romania.

出版信息

Nutrients. 2023 Feb 23;15(5):1134. doi: 10.3390/nu15051134.

DOI:10.3390/nu15051134

PMID:36904134

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10005116/

Abstract

BACKGROUND

As obesity rates continue to rise worldwide, many surgeons consider bariatric procedures as a possible cure for the upcoming obesity pandemic. Excess weight represents a risk factor for multiple metabolic disorders, especially for type 2 diabetes mellitus (T2DM). There is a strong correlation between the two pathologies. The aim of this study is to highlight the safety and short-term results of laparoscopic sleeve gastrectomy (LSG), Roux-en-Y gastric bypass (RYGB, laparoscopic gastric plication (LGP) and intragastric balloon (IGB) as methods used in the treatment of obesity. We followed the remission or amelioration of comorbidities, tracked metabolic parameters, weight loss curves and hoped to outline the profile of the obese patient in Romania.

METHODS

The target population of this study was represented by patients (n = 488) with severe obesity who qualified for the metabolic surgery criteria. Starting from 2013 to 2019, patients underwent four types of bariatric procedures and were subsequently monitored over the course of 12 months in the 3rd Surgical Clinic at "Sf. Spiridon" Emergency Hospital Iași. Descriptive evaluation indicators, as well as those of analytical evaluation were used as statistical processing methods.

RESULTS

A significant decrease in body weight was recorded during monitoring and was more pronounced for patients who underwent LSG and RYGB. T2DM was identified in 24.6% of patients. Partial remission of T2DM was present in 25.3% of cases, and total remission was identified in 61.4% of patients. Mean blood glucose levels, triglycerides, LDL and total cholesterol levels decreased significantly during monitoring. Vitamin D increased significantly regardless of the type of surgery performed, while mean levels of vitamin B12 decreased significantly during monitoring. Post-operative intraperitoneal bleeding occurred in 6 cases (1.22%) and a reintervention for haemostasis was required.

CONCLUSIONS

All procedures performed were safe and effective methods of weight loss and improved associated comorbidities and metabolic parameters.

摘要

背景

随着全球肥胖率的不断上升，许多外科医生将减重手术视为即将到来的肥胖流行的一种可能的治疗方法。超重是多种代谢紊乱的危险因素，尤其是 2 型糖尿病（T2DM）。这两种病理之间存在很强的相关性。本研究旨在强调腹腔镜袖状胃切除术（LSG）、Roux-en-Y 胃旁路术（RYGB、腹腔镜胃折叠术（LGP）和胃内球囊（IGB）作为治疗肥胖症的方法的安全性和短期结果。我们关注并发症的缓解或改善，跟踪代谢参数、体重减轻曲线，并希望勾勒出罗马尼亚肥胖患者的特征。

方法

本研究的目标人群是符合代谢手术标准的严重肥胖患者（n=488）。从 2013 年到 2019 年，患者接受了四种减重手术，随后在雅西“圣斯皮里东”急救医院的第 3 外科诊所进行了 12 个月的监测。采用描述性评估指标和分析性评估指标作为统计处理方法。

结果

监测期间体重明显下降，LSG 和 RYGB 患者下降更为明显。24.6%的患者诊断为 2 型糖尿病。25.3%的患者部分缓解 2 型糖尿病，61.4%的患者完全缓解。监测期间，平均血糖、甘油三酯、LDL 和总胆固醇水平显著下降。无论手术类型如何，维生素 D 水平均显著升高，而维生素 B12 水平在监测期间显著下降。6 例（1.22%）发生术后腹腔内出血，需要再次手术止血。