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腹腔镜单吻合十二指肠空肠旁路术与袖状胃切除术及腹腔镜Roux-en-Y胃旁路术对肥胖患者短期疗效的比较

Comparison of Laparoscopic Single-Anastomosis Duodenal-Jejunal Bypass With Sleeve Gastrectomy and Laparoscopic Roux-en-Y Gastric Bypass on Short-term Outcomes in Patients With Obesity.

作者信息

Kim Sang Hyun

机构信息

Department of Surgery, Soonchunhyang University Seoul Hospital, Seoul, Korea.

出版信息

J Metab Bariatr Surg. 2025 Apr;14(1):43-52. doi: 10.17476/jmbs.2025.14.1.43. Epub 2025 Apr 24.

Abstract

PURPOSE

The aim of this study was to compare postoperative course of laparoscopic single-anastomosis duodenal-jejunal bypass with sleeve gastrectomy (SADJB-SG) and laparoscopic Roux-en-Y gastric bypass (RYGB) during a 1-year follow-up period.

MATERIALS AND METHODS

Electronic medical records of all patients who underwent SADJB-SG and RYGB between March 2019 and June 2021 at a single institution were retrospectively reviewed. Surgical outcomes, weight loss, resolution of co-morbidities, episode of dumping syndrome, and marginal ulcer at endoscopy were assessed.

RESULTS

Eighty-four patients who underwent SADJB-SG and RYGB were enrolled. One-year follow-up rate was 78.6%. There were no significant differences in operative time, estimated blood loss, length of postoperative stay, postoperative complications, readmission, or reoperation rate between SADJB-SG and RYGB. Percent of total weight loss (%TWL) was 26.9±9.3% in SADJB-SG and 29.6±7.6% in RYGB (P=0.209). Remission rates of T2DM, hypertension, dyslipidemia, and GERD were 78.3%, 63.6%, 44.4%, and 40% in SADJB-SG and 71.4%, 52.9%, 56.2%, and 12.5% in RYGB (P=0.318, P=0.480, P=0.417, and P=0.561), respectively. Episodes of dumping syndrome and marginal ulcer at endoscopy showed rates of 0% and 0% in SADJB-SG and 33.4% and 15.8% in RYGB (P=0.002 and P=0.043), respectively.

CONCLUSION

SADJB-SG is comparable to RYGB in terms of perioperative outcomes, weight loss, and resolution of co-morbidities. It is advantageous in terms of dumping syndrome and marginal ulcer during 1-year follow-up.

摘要

目的

本研究旨在比较腹腔镜下单吻合十二指肠空肠旁路术联合袖状胃切除术(SADJB-SG)与腹腔镜Roux-en-Y胃旁路术(RYGB)在1年随访期内的术后病程。

材料与方法

回顾性分析2019年3月至2021年6月在单一机构接受SADJB-SG和RYGB的所有患者的电子病历。评估手术结果、体重减轻情况、合并症的缓解情况、倾倒综合征发作情况以及内镜检查时的边缘溃疡情况。

结果

84例接受SADJB-SG和RYGB的患者入组。1年随访率为78.6%。SADJB-SG和RYGB在手术时间、估计失血量、术后住院时间、术后并发症、再次入院率或再次手术率方面无显著差异。SADJB-SG的总体重减轻百分比(%TWL)为26.9±9.3%,RYGB为29.6±7.6%(P=0.209)。SADJB-SG中2型糖尿病、高血压、血脂异常和胃食管反流病(GERD)的缓解率分别为78.3%、63.6%、44.4%和40%,RYGB中分别为71.4%、52.9%、56.2%和12.5%(P=0.318、P=0.480、P=0.417和P=0.561)。SADJB-SG中倾倒综合征发作情况和内镜检查时边缘溃疡的发生率分别为0%和0%,RYGB中分别为33.4%和15.8%(P=0.002和P=0.043)。

结论

SADJB-SG在围手术期结果、体重减轻和合并症缓解方面与RYGB相当。在1年随访期间,SADJB-SG在倾倒综合征和边缘溃疡方面具有优势。

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