Singla Vitish, Gupta Aishwary, Gupta Aishwary, Monga Sukhda, Kumar Arun, Chekuri Ritvik, Gupta Mehul, Kashyap Lokesh, Aggarwal Sandeep
Department of Surgical Disciplines, India Institute of Medical Sciences, Room No. 5034, New Delhi, India.
Department of Anesthesiology, India Institute of Medical Sciences, New Delhi, India.
Obes Surg. 2024 Jan;34(1):43-50. doi: 10.1007/s11695-023-06960-1. Epub 2023 Nov 24.
The data comparing laparoscopic sleeve gastrectomy (LSG) and one-anastomosis gastric bypass (OAGB) in patients with BMI ≥ 60 kg/m is scarce.
Prospectively collected data of patients with BMI ≥ 60 kg/m undergoing LSG or OAGB from January 2008 until June 2022 was analyzed retrospectively. Weight loss outcomes, impact on comorbidities, and complications were compared in both groups.
Fifty-six patients underwent LSG and 13 patients underwent OAGB. The median age and BMI were 37 (34-44) years and 63 (61.3-64.6) kg/m respectively. Both the groups had similar baseline demographic parameters. The percentage excess BMI loss (%EBMIL) was statistically similar in LSG and OAGB groups at 1 year (46.2% vs 46.1%), 3 years (52.9% vs 56.7%), and 5 years (51.1% vs 62.3%). The percentage excess BMI regain was lower (although statistically similar) following OAGB at 3 years (5.3% vs 0.1%) and 5 years (12.9% vs 4.4%). OAGB was found to correlate positively with weight loss and negatively with weight regain (p > 0.05). There was one 30-day mortality due to postoperative lower respiratory infection in the LSG group.
OAGB has a trend towards better weight loss outcomes as compared to LSG in patients with a BMI ≥ 60 kg/m with lesser complication rates and might be a preferred option. LSG also has acceptable weight loss and should be considered a standalone procedure if OAGB is not feasible technically.
关于体重指数（BMI）≥60kg/m²的患者接受腹腔镜袖状胃切除术（LSG）和单吻合口胃旁路术（OAGB）的对比数据较少。
回顾性分析2008年1月至2022年6月期间前瞻性收集的BMI≥60kg/m²且接受LSG或OAGB的患者数据。比较两组的体重减轻结果、对合并症的影响及并发症情况。
56例患者接受了LSG，13例患者接受了OAGB。中位年龄和BMI分别为37（34 - 44）岁和63（61.3 - 64.6）kg/m²。两组的基线人口统计学参数相似。LSG组和OAGB组在1年时的超重BMI损失百分比（%EBMIL）在统计学上相似（46.2%对46.1%），3年时（52.9%对56.7%），5年时（51.1%对62.3%）。OAGB术后3年（5.3%对0.1%）和5年（12.9%对4.4%）的超重BMI恢复百分比更低（尽管在统计学上相似）。发现OAGB与体重减轻呈正相关，与体重恢复呈负相关（p＞0.05）。LSG组有1例因术后下呼吸道感染导致的30天死亡率。
对于BMI≥60kg/m²的患者，与LSG相比，OAGB有减重效果更好的趋势，并发症发生率更低，可能是一个更优选择。LSG也有可接受的减重效果，如果OAGB在技术上不可行，应将其视为一种独立的手术方式。
