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单吻合口胃旁路术是一种好的减重手术修正术式吗?一项单中心回顾性队列研究。

Is one-anastomosis gastric bypass a good revisional bariatric surgery? A single-center retrospective cohort study.

机构信息

Department of General, Minimally Invasive and Elderly Surgery, Collegium Medicum, University of Warmia and Mazury, Olsztyn, Poland.

出版信息

Pol Przegl Chir. 2023 Oct 12;96(1):49-56. doi: 10.5604/01.3001.0053.9293.

DOI:10.5604/01.3001.0053.9293
PMID:38353091
Abstract

<b><br>Introduction:</b> The rate of revisional surgeries following sleeve gastrectomy (SG) has increased. One-anastomosis gastric bypass (OAGB) appears to have multiple advantages as a primary bariatric procedure. OAGB as revisional surgery is still being investigated.</br> <b><br>Aim:</b> Evaluation of the efficacy and safety of OAGB performed as a post-SG revisional surgery.</br> <b><br>Materials and methods:</b> A single-center, retrospective cohort study was conducted using a routinely collected database of adults undergoing revisional OAGB after SG. A survey of patients was conducted, obtaining information on changes in body weight and improvement in gastroesophageal reflux disease (GERD) and obesity-related diseases.</br> <b><br>Results:</b> The study group included 74 patients: 59 women (80%) and 15 men, mean age of 41.61 9.21 years. The most common indication for OAGB was weight regain. The follow-up was up to 7 years, the mean time was 3.58 1.21 years. The mean preoperative body mass index (BMI) was 40.38 6.15. All patients experienced significant weight loss, reaching a BMI of 33.61 (27.28- 37.13) at the last observation. After surgery, 35% of patients achieved successful weight loss and 48% of patients achieved remission or improvement of GERD.</br> <b><br>Conclusions:</b> Revisional OAGB seems to be a good alternative after a failed SG in terms of obesity-related disease recurrence, not of weight regain. Long-term follow-up revealed that only a third of patients achieved successful weight loss. When proposing revisional OAGB, the risk of complications - mainly anemia and the possibility of de novo GERD should be considered.</br&gt.

摘要

<b><br>引言:</b>袖状胃切除术(SG)后再次手术的比率有所增加。单吻合胃旁路术(OAGB)作为一种主要的减肥手术似乎具有多种优势。OAGB 作为再次手术的治疗方法仍在研究中。</br> <b><br>目的:</b>评估 OAGB 作为 SG 后的再次手术的疗效和安全性。</br> <b><br>材料和方法:</b>对在 SG 后进行再次 OAGB 的成年人的常规收集数据库进行了单中心回顾性队列研究。对患者进行了调查,以获得体重变化、胃食管反流病(GERD)和肥胖相关疾病改善的信息。</br> <b><br>结果:</b>研究组包括 74 例患者:59 名女性(80%)和 15 名男性,平均年龄为 41.61 9.21 岁。OAGB 的最常见指征是体重反弹。随访时间长达 7 年,平均时间为 3.58 1.21 年。术前平均体重指数(BMI)为 40.38 6.15。所有患者均经历了显著的体重减轻,最后一次观察时 BMI 达到 33.61(27.28-37.13)。手术后,35%的患者成功减肥,48%的患者 GERD 得到缓解或改善。</br> <b><br>结论:</b>在 SG 失败后,再次 OAGB 似乎是一种治疗肥胖相关疾病复发而非体重反弹的较好选择。长期随访显示,只有三分之一的患者达到了成功减肥的目标。在提出再次 OAGB 时,应考虑并发症的风险——主要是贫血和新发 GERD 的可能性。</br>

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