Okazumi Shinichi, Oshiro Takashi, Sasaki Akira, Matsubara Hisahiro, Tatsuno Ichiro
Japanese Society for Treatment of Obesity, Tokyo 113-0033, Japan.
Department of Surgery, Toho University Sakura Medical Center, 564-1, Shimoshizu, Sakura 285-8741, Japan.
J Clin Med. 2023 Jun 27;12(13):4303. doi: 10.3390/jcm12134303.
In Japan, bariatric surgical treatment was started in 1982. The Japanese Society for Treatment of Obesity (JSTO) was established in 2007, and then, JSTO started the national registry of bariatric surgery cases and multidisciplinary educational program. A total of 44 facilities registered 4055 bariatric surgical cases until 2021. In this study, the purpose is to clarify the indication, the safety and the effectiveness of the sleeve gastrectomy using national registry database compiled by JSTO. Preoperative BMI ranged from 27.6 to 90.7 kg/m, and the mean value was 42.7. With regard to gender, men/women was 1/1.3. Age was 42.2 as mean. As preoperative comorbidities, DM ratio was 54.4% of the patients, hypertension 64.5%, dyslipidemia 65.1%, and sleep apnea syndrome 69.8%. As an operation method, laparoscopic method was conducted in 99.7% of the cases. The intraoperative incidence rate was 0.9%. Conversion rate to open method was 1.1%. Postoperative morbidity ratio was 5.6%, and mortality was 0%. Reoperations were performed in 1.5% of the cases. Postoperative hospital stay was 5 days in median value. Body weight loss was 27.6 kg in the mean value after follow-up days of 279 ± 245. As the effect on the preoperative metabolic comorbidities, DM has improved in 82.9% of the cases, hypertension 67.9% and dyslipidemia 66.6%. In conclusion, using JSTO database, we evaluated the indication, postoperative complications and weight loss effect of sleeve gastrectomy in Japan. Regarding the evaluation of the effect on preoperative comorbidities, future follow-up based on more detailed criteria was considered to be necessary.
在日本,减重手术治疗始于1982年。日本肥胖治疗学会(JSTO)于2007年成立,随后,JSTO启动了减重手术病例的全国登记和多学科教育项目。截至2021年,共有44家机构登记了4055例减重手术病例。在本研究中,目的是利用JSTO编制的全国登记数据库阐明袖状胃切除术的适应症、安全性和有效性。术前体重指数范围为27.6至90.7kg/m,平均值为42.7。关于性别,男性/女性为1/1.3。平均年龄为42.2岁。作为术前合并症,糖尿病患者比例为54.4%,高血压为64.5%,血脂异常为65.1%,睡眠呼吸暂停综合征为69.8%。作为手术方法,99.7%的病例采用腹腔镜手术。术中发生率为0.9%。转为开放手术的比例为1.1%。术后发病率为5.6%,死亡率为0%。1.5%的病例进行了再次手术。术后住院时间中位数为5天。随访279±245天后,体重平均减轻27.6kg。作为对术前代谢合并症的影响,82.9%的糖尿病病例得到改善,高血压为67.9%,血脂异常为66.6%。总之,利用JSTO数据库,我们评估了日本袖状胃切除术的适应症、术后并发症和减重效果。关于对术前合并症影响的评估,认为有必要根据更详细的标准进行未来随访。