Department of General Surgery, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, Jiangsu, China.
Obes Surg. 2023 Nov;33(11):3545-3564. doi: 10.1007/s11695-023-06805-x. Epub 2023 Sep 13.
Major BMS are modified through loop rather than Roux-en-Y type reconstruction recently, and this study systematically reviews the BMS from the perspective of SA (single anastomosis) and DA (double anastomosis) procedures, aiming to research the differences among bariatric procedures. A total of 39 studies compared SA- and DA-BMS were finally eligible for analysis after searching in PubMed, Web of Science, and Cochrane Library. Compared with DA, SA shortens operative time and decreases complications especially obstruction, internal hernia, and reoperation. SA-GB (gastric bypass) has significantly higher %TWL and T2DM remission rate than DA-GB 1- and 5-year postoperatively. SA-DS (duodenal switch) has similar 1-year %TWL and lower 5-year %TWL, and comparable 1- and 5-year T2DM remission with DA-DS. SA provides significant advantages about simplicity and safety. This, together with the shorter learning curve, makes SA a promising choice.
最近，主要的胆肠吻合术通过吻合环而不是 Roux-en-Y 型重建来进行修改，本研究从单吻合口（SA）和双吻合口（DA）手术的角度系统地回顾了胆肠吻合术，旨在研究减肥手术之间的差异。在 PubMed、Web of Science 和 Cochrane Library 中搜索后，最终有 39 项研究比较了 SA 和 DA-BMS 符合纳入标准。与 DA 相比，SA 缩短了手术时间，减少了并发症，特别是梗阻、内疝和再次手术。SA-GB（胃旁路术）在术后 1 年和 5 年时的体重减轻百分比（%TWL）和 T2DM 缓解率显著高于 DA-GB。SA-DS（十二指肠转位术）在术后 1 年时的体重减轻百分比（%TWL）相似，但 5 年时的体重减轻百分比较低，与 DA-DS 的 1 年和 5 年 T2DM 缓解率相当。SA 具有简单和安全的显著优势。这一点，加上较短的学习曲线，使 SA 成为一种很有前途的选择。
