Gutiérrez-Ramírez Lucía, Morandeira-Rivas Antonio, Medina-Benítez Elisa, Arias-Arias Ángel, Moreno-Sanz Carlos
Research Support Unit, Hospital Universitario Mancha Centro, 13600, Alcázar de San Juan, Spain.
Instituto de Investigaciones Sanitarias de Castilla-La Mancha (IDISCAM), 45071, Toledo, Spain.
Obes Surg. 2024 Dec;34(12):4519-4530. doi: 10.1007/s11695-024-07555-0. Epub 2024 Oct 29.
This systematic review evaluated the safety and efficacy of reduced port laparoscopic sleeve gastrectomy and compared its potential advantages over the conventional laparoscopic approach. Eighteen eligible articles were analyzed, including thirteen cohort studies and five randomized trials (n = 2945). There were no differences in total postoperative complications [OR of 0.99 (0.72 to 1.37)] nor those classified as Clavien-Dindo ≥ IIIb. There were also no differences regarding operative time, blood loss, postoperative pain, weight loss, and improvement in comorbidities. In the reduced port group, hospital stay was slightly shorter [WDM of - 0.23 (- 0.39 to - 0.07)], and cosmetic results were better in the short term. Our meta-analysis shows reduced port sleeve gastrectomy can be safely performed in selected patients, although clinical benefits are unclear (PROSPERO (CRD42022372829)).
本系统评价评估了减少端口腹腔镜袖状胃切除术的安全性和有效性，并比较了其相对于传统腹腔镜手术方法的潜在优势。分析了18篇符合条件的文章，包括13项队列研究和5项随机试验（n = 2945）。术后总并发症[比值比为0.99（0.72至1.37）]以及分类为Clavien-Dindo≥IIIb级的并发症均无差异。在手术时间、失血量、术后疼痛、体重减轻和合并症改善方面也没有差异。在减少端口组中，住院时间略短[加权差值为-0.23（-0.39至-0.07）]，短期内美容效果更好。我们的荟萃分析表明，减少端口袖状胃切除术可以在选定的患者中安全进行，尽管临床益处尚不清楚（国际前瞻性系统评价注册库（CRD42022372829））。
