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分析袖状胃切除术、单吻合口胃旁路术和单吻合口空肠旁路术治疗代谢综合征的疗效。

Analysis of the efficacy of sleeve gastrectomy, one-anastomosis gastric bypass, and single-anastomosis sleeve ileal bypass in the treatment of metabolic syndrome.

机构信息

Nanjing Drum Tower Hospital, Clinical College of Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, 210008, China.

Department of Pancreatic and Metabolic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Medical School, Nanjing University, Nanjing, 210008, China.

出版信息

Sci Rep. 2024 Mar 1;14(1):5069. doi: 10.1038/s41598-024-54949-2.

Abstract

The objective of this study was to evaluate and compare the effectiveness of three different types of bariatric surgeries, namely, sleeve gastrectomy (SG), one-anastomotic gastric bypass (OAGB), and single anastomosis sleeve ileal (SASI) bypass, in the treatment of metabolic syndrome (MS). The optimal approach for managing MS remains uncertain, and thus this study aimed to provide a recent analysis of the efficacy of these surgical procedures. This retrospective study evaluated data of individuals who underwent SG, OAGB, and SASI bypass. The primary outcome measures included weight, body mass index (BMI), glucolipid metabolic index, and the occurrence of treatment-related complications within 6 to 12 months post-surgery. A total of 324 patients were included in this study. Of these, 264 patients underwent SG, 30 underwent OAGB, and 30 underwent SASI bypass. A significant decrease in weight was observed at the 6-month and 12-month marks following all three surgical procedures. Of these, patients who underwent SASI bypass exhibited the greatest reduction in weight and BMI post-surgery. Furthermore, the SASI bypass was associated with a significantly higher percentage of total weight loss (%TWL) and excess body mass index loss (%EBMIL) compared to SG and OAGB. Patients who underwent OAGB and SASI bypass demonstrated notable improvements in type 2 diabetes mellitus (T2DM). Patients who underwent SASI bypass and OAGB experienced greater postoperative comfort and reported fewer complaints of discomfort compared to the other procedure. Based on the retrospective analysis of the data, SASI bypass was associated with greater reductions in weight and BMI, higher percentages of %TWL and %EBMIL, and better improvement in T2DM compared to SG and OAGB. Therefore, both SASI bypass and OAGB were found to be more effective than SG in the treatment of MS.

摘要

本研究旨在评估和比较三种不同类型的减重手术(袖状胃切除术[SG]、单吻合口胃旁路术[OAGB]和单吻合口空肠旁路术[SASI])在治疗代谢综合征(MS)方面的效果。治疗 MS 的最佳方法仍不确定,因此本研究旨在对这些手术的疗效进行近期分析。本回顾性研究评估了接受 SG、OAGB 和 SASI 旁路手术的个体数据。主要观察指标包括体重、体重指数(BMI)、糖脂代谢指数以及术后 6-12 个月内治疗相关并发症的发生情况。共纳入 324 例患者,其中 264 例行 SG,30 例行 OAGB,30 例行 SASI 旁路手术。所有三种手术在术后 6 个月和 12 个月时体重均明显下降,其中 SASI 旁路手术后体重和 BMI 下降幅度最大。此外,与 SG 和 OAGB 相比,SASI 旁路手术后总体重减轻率(%TWL)和多余体重指数减轻率(%EBMIL)显著更高。行 OAGB 和 SASI 旁路手术的患者 2 型糖尿病(T2DM)显著改善。行 SASI 旁路和 OAGB 手术的患者术后舒适度明显提高,与其他手术相比,抱怨不适的情况更少。基于数据的回顾性分析,SASI 旁路手术后体重和 BMI 下降幅度更大,%TWL 和 %EBMIL 百分比更高,T2DM 改善情况更好,与 SG 和 OAGB 相比,SASI 旁路手术更有效。因此,SASI 旁路和 OAGB 均比 SG 更有效治疗 MS。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a9b2/10907579/93af733b4873/41598_2024_54949_Fig1_HTML.jpg

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