Mutlu Vahit, Yüksek Mahmut Arif, Koca Bülent, Özbalcı Gökhan Selçuk
Department of General Surgery, Uskudar University, İstanbul, Turkey.
Faculty of Medicine, General Surgery Department, Hitit University, Çorum, Turkey.
BMC Surg. 2025 May 19;25(1):217. doi: 10.1186/s12893-025-02952-3.
Obesity and accompanying comorbidities are serious diseases that impair the quality of life and even threaten human life. Today, the most effective method for providing sustainable weight loss in the treatment of obesity is Bariatric and Metabolic Surgery procedures. In our study, we aimed to compare the therapeutic effects of Laparoscopic Sleeve Gastrectomy (LSG) and One Anastomosis Gastric Bypass (OAGB) on metabolic syndrome components. We also planned to investigate the complications after bariatric and metabolic surgery, whether the patients had recurrent weight gain, and the short, medium and long-term effects.
Patients who underwent bariatric and metabolic surgery with the diagnosis of obesity between December 2012-January 2020 were retrospectively analyzed. 561 patients who were followed up at 3, 6 months, 1, 2 and 3 years after the operation were included in the study. The effects of bariatric and metabolic surgery on metabolic syndrome components were evaluated as partial and complete remission according to the status at the last follow-up. Statistical analysis were performed by SPSS 18. Results were reported as mean ± standard deviation. P < 0.05 was accepted as statistical significance.
In 516 patients who underwent LSG and 45 patients who underwent OAGB, a decrease in BMI and an increase in EWL(%) values were observed at the 3rd month, 6th month, 1st year and 2nd year controls. In the 3rd year controls of patients who underwent LSG, recurrent weight gain was observed, therefore there was an increase in BMI and a decrease in EWL(%) values compared to the 2nd year. In patients who underwent OAGB, a decrease in BMI continued at the 3rd year, while an increase in EWL(%) values was observed. Thanks to both LSG and OAGB; a remission was achieved at the rates of DM, HT, HL/DL, OSAS, hypothyroidism in the early period. As the follow-up period extended, the rate of patients showing complete recovery decreased for DM(p = 0.0001). No change was observed during the follow-up period for other parameters. CONCLUSıON: Therapeutic effects of LSG and OAGB on metabolic syndrome components have been demonstrated in our study. However, when DM remission and sustainable weight loss are evaluated, OAGB is more effective in the long term.
肥胖及其伴随的合并症是严重疾病，会损害生活质量甚至威胁人类生命。如今，在肥胖治疗中实现可持续减重的最有效方法是减重代谢手术。在我们的研究中，我们旨在比较腹腔镜袖状胃切除术（LSG）和单吻合口胃旁路术（OAGB）对代谢综合征各组分的治疗效果。我们还计划调查减重代谢手术后的并发症、患者是否出现体重反弹以及短期、中期和长期效果。
对2012年12月至2020年1月期间接受减重代谢手术且诊断为肥胖的患者进行回顾性分析。纳入561例术后3个月、6个月、1年、2年和3年接受随访的患者。根据最后一次随访时的情况，将减重代谢手术对代谢综合征各组分的影响评估为部分缓解和完全缓解。采用SPSS 18进行统计分析。结果以均值±标准差表示。P < 0.05被视为具有统计学意义。
在接受LSG的516例患者和接受OAGB的45例患者中，在第3个月、第6个月、第1年和第2年的复查中观察到BMI下降和EWL（%）值增加。在接受LSG的患者第3年复查时，观察到体重反弹，因此与第2年相比，BMI增加且EWL（%）值下降。在接受OAGB的患者中，第3年BMI持续下降，同时EWL（%）值增加。得益于LSG和OAGB，早期糖尿病（DM）、高血压（HT）、高脂蛋白血症/血脂异常（HL/DL）、阻塞性睡眠呼吸暂停低通气综合征（OSAS）、甲状腺功能减退症均实现了一定比例的缓解。随着随访期延长，DM患者完全康复的比例下降（p = 0.0001）。随访期间其他参数未见变化。结论：我们的研究证实了LSG和OAGB对代谢综合征各组分的治疗效果。然而，在评估DM缓解和可持续减重时，OAGB长期效果更佳。
