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腹腔镜袖状胃切除术联合转流环二分法和转流二分法治疗肥胖 2 型糖尿病患者:回顾性分析。

Laparoscopic Sleeve Gastrectomy With Transit Loop Bipartition and Transit Bipartition in Type 2 Diabetic Patients With Obesity: A Retrospective Analysis.

机构信息

Department of Endocrinology and Metabolism, Atilim University School of Medicine.

Department of General Surgery, Ankara Obesity Surgery Clinic.

出版信息

Surg Laparosc Endosc Percutan Tech. 2023 Aug 1;33(4):357-364. doi: 10.1097/SLE.0000000000001189.

DOI:10.1097/SLE.0000000000001189
PMID:37343192
Abstract

AIM

We aimed to compare 1-year postoperative results of patients with obesity and type 2 diabetes mellitus (T2DM) who underwent laparoscopic sleeve gastrectomy with transit bipartition (LSG-TB) and transit loop bipartition (LSG-TLB) and mini gastric bypass (MGB).

PATIENTS AND METHODS

This is a retrospective comparison of 2 novel bariatric surgery techniques with MGB. Primary outcome measure of the study was a rate of T2DM remission. Secondary outcomes included excess body mass index (BMI) loss, improvement in hepatosteatosis, and duration of operation. Revision surgery needs were also assessed.

RESULTS

Overall, 32 patients underwent the LSG-TLB, 15 underwent LSG-TB, and 50 underwent MGB. Mean age and sex distribution were comparable for all groups. Presurgical BMI was similar in MGB and LSG + TB groups, whereas LSG + TLB group had significantly lower BMI values compared with the MGB group. In both groups, BMI values reduced significantly compared with respective baseline values. Excess BMI loss was significantly higher in patients who underwent LSG-TLB compared with patients treated with LSG-TB and MGB. Bariatric surgery procedures lasted shorter in LSG-TLB than in LSG-TB. However, the shortest of all was MGB. The remission of T2DM rates were 71% and 73.3% in LSG-TLB and LSG-TB groups, respectively ( P > 9.999). The rate of revision surgeries was comparable in both groups.

CONCLUSION

In conclusion, LSG-TLB took less time and provided significantly higher excess BMI loss compared with LSG-TB. T2DM remission and improvement rates were similar in both groups. LSG-TLB seemed like a promising bariatric surgery technique in patients with obesity and T2DM.

摘要

目的

我们旨在比较肥胖合并 2 型糖尿病(T2DM)患者行腹腔镜袖状胃切除术联合转流 2 分区(LSG-TB)和转流环 2 分区(LSG-TLB)与迷你胃旁路术(MGB)的 1 年术后结果。

患者和方法

这是一项将 2 种新型减重手术与 MGB 进行回顾性比较的研究。研究的主要观察指标是 T2DM 缓解率。次要结果包括超重体重指数(BMI)减轻率、肝脂肪变性改善和手术时间。还评估了再次手术的需求。

结果

共有 32 例患者行 LSG-TLB,15 例行 LSG-TB,50 例行 MGB。所有组的平均年龄和性别分布相似。MGB 和 LSG+TB 组的术前 BMI 相似,而 LSG+TLB 组的 BMI 值明显低于 MGB 组。两组患者的 BMI 值均较各自的基线值显著降低。与 LSG-TB 和 MGB 治疗的患者相比,LSG-TLB 组患者的超重 BMI 减轻率显著更高。LSG-TLB 手术时间短于 LSG-TB,但所有手术中最短的是 MGB。LSG-TLB 和 LSG-TB 组的 T2DM 缓解率分别为 71%和 73.3%(P>9.999)。两组的再次手术率相当。

结论

总之,LSG-TLB 与 LSG-TB 相比,手术时间更短,超重 BMI 减轻率显著更高。两组的 T2DM 缓解率和改善率相似。LSG-TLB 似乎是肥胖合并 T2DM 患者有前途的减重手术技术。

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