Lind Romulo, Hage Karl, Ghanem Muhammad, Shah Meera, Vierkant Robert A, Jawad Muhammad, Ghanem Omar M, Teixeira Andre F
Department of Bariatric Surgery, Orlando Regional Medical Center, Orlando Health, 89 W Copeland Dr., 1st Floor, Orlando Health, Orlando, FL, USA.
Department of Surgery, Mayo Clinic, Rochester, MN, USA.
Obes Surg. 2023 Oct;33(10):3028-3034. doi: 10.1007/s11695-023-06730-z. Epub 2023 Jul 18.
Sleeve gastrectomy (SG) is an effective procedure with remarkable weight loss and low complication rates. However, up to 30% of cases require revisional surgery in non-responders or patients who experience weight recurrence. We aim to report the rate of weight recurrence/non-responders (WR/NR) in patients who underwent SG and had more than 5 years of follow-up.
We performed a multicenter retrospective study of patients who underwent initial SG from 2008 to 2017. Patient demographics and weight loss outcomes up to 12 years after SG were collected. Surgical non-responders were defined as 20% weight regain compared to maximum weight loss. A chi-square test for categorical variables and a two-sample t-test for continuous variables were used. Data are summarized as mean ± standard deviation.
From a total of 1263 patients, we included 339 patients (78% female, age 47.3 ± 11.2 years; baseline weight 125.8 ± 27.6 kg) with at least 5 years of follow-up (mean follow-up of 7.1 ± 1.8 years) (Table 1). Surgical non-response was demonstrated in 15.9% of patients (n=54) and 64.0% (n=217) had weight recurrence after SG (Fig. 1). There was a statistically significant difference in history of hypertension (p=0.046) and diabetes (p=0.032) as well as %TBWL at 1 year (p=0.005) and at longest follow-up (p<0.001) between patients who experienced WR/NR and those who did not.
Only 20% of patients who underwent SG and followed up for more than 5 years were able to maintain appropriate weight loss.
袖状胃切除术（SG）是一种有效的手术方法，能实现显著的体重减轻且并发症发生率低。然而，高达30%的病例在无反应者或体重复发的患者中需要进行翻修手术。我们旨在报告接受袖状胃切除术且随访超过5年的患者的体重复发/无反应率（WR/NR）。
我们对2008年至2017年接受初次袖状胃切除术的患者进行了一项多中心回顾性研究。收集了患者的人口统计学数据以及袖状胃切除术后长达12年的体重减轻结果。手术无反应者定义为与最大体重减轻相比体重恢复20%。对分类变量使用卡方检验，对连续变量使用双样本t检验。数据以均值±标准差表示。
在总共1263例患者中，我们纳入了339例患者（78%为女性，年龄47.3±11.2岁；基线体重125.8±27.6千克），其随访时间至少为5年（平均随访7.1±1.8年）（表1）。15.9%的患者（n = 54）表现为手术无反应，64.0%（n = 217）的患者在袖状胃切除术后出现体重复发（图1）。经历WR/NR的患者与未经历者之间在高血压病史（p = 0.046）、糖尿病病史（p = 0.032）以及1年时的%TBWL（p = 0.005）和最长随访时的%TBWL（p < 0.001）方面存在统计学显著差异。
接受袖状胃切除术并随访超过5年的患者中，只有20%能够维持适当的体重减轻。
