腹腔镜胃袖状切除加空回肠侧侧吻合术在治疗肥胖症中的应用价值  

Application value of laparoscopic sleeve gastrectomy plus side-to-side jejunoileal anastomosis in treating obesity

作　　者：马颖璋[1] 朱江帆[1] 忻颖[1] 唐霖[1] 陆佳军 陆伟[1] 彭建佩 Ma Yingzhang Zhu Jiangfan Xin Ying Tang Lin Lu Jiajun Lu Wei Peng Jianpei(Department of Diabetic and Bariatric Surgery, Dongfang Hospital Affiliated to Tongji University, Shanghai 200124, China)

机构地区：[1]同济大学附属东方医院糖尿病与减重外科,上海200124

出　　处：《中华肥胖与代谢病电子杂志》2016年第3期142-145,共4页Chinese Journal Of Obesity and Metabolic Diseases：Electronic Edition

摘　　要：目的探讨腹腔镜胃袖状切除加空回肠侧侧吻合术(laparoscopic sleeve gastrectomy plus side-to-side jejunoileal anastomosis,JI-LSG)在治疗肥胖症中的应用价值。方法回顾性分析2014年3月至2016年4月在同济大学附属东方医院糖尿病与减重外科接受代谢手术治疗的18例肥胖症患者的临床资料。所有患者均签署知情同意书,符合医学伦理学规定。根据接受手术方式的不同将患者分为JI-LSG组和腹腔镜袖状胃切除术(laparoscopic sleeve gastrectomy,LSG)组。其中JI-LSG组9例,男5例,女4例;平均年龄(31±9)岁。LSG组9例,男5例,女4例;平均年龄(31±10)岁。比较两组患者的手术时间、术中出血量、术后住院时间、术后并发症发生情况,以及术后6个月内的体质指数(body mass index,BMI)减少量、多余体重减少百分比(percentage of excess body weight loss,EWL%)和代谢病缓解情况。两组患者临床资料的比较采用t检验和Fisher确切概率法。结果 JI-LSG组患者术后并发症发生率为33%(3/9),与LSG组的22%(2/9)差异无统计学意义(P=0.599)。术后6个月,JI-LSG组患者的BMI减少量和EWL%分别为(15±6)kg/m2和(76±27)%,明显高于LSG组的(10±5)kg/m2和(54±29)%(t=4.60、4.18,P<0.05);两组患者的肥胖相关合并症均得到显著改善。结论 JI-LSG操作难度不高,简单易行,有良好的治疗肥胖症和代谢综合征的疗效,但该术式处于应用初期,需进一步研究以明确其价值。ObjectiveTo investigate the clinical application value of laparoscopic sleeve gastrectomy plus side-to-side jejunoileal anastomosis （JI-SG） in treating obesity.Methods Clinical data of 18 obese patients undergoing metabolic surgery in the Department of Diabetic and Bariatric Surgery in Dongfang Hospital Affiliated to Tongji University between March 2014 and April 2016 were retrospectively studied. The informed consents of all patients were obtained and the local ethical committee approval had been received. The patients were divided into the JI-LSG group and the laparoscopic sleeve gastrectomy （LSG） group according to different surgical approaches. Among the 9 patients of JI-LSG group, 5 were males and 4 were females with an average age of （31±9） years old. Among the 9 patients of LSG group, 5 were males and 4 were females with an average age of （31±10） years old. Operation time, intraoperative blood loss, postoperative hospital stay, postoperative complication and body mass index （BMI） loss, percentage of excess body weight loss （EWL%） and metabolic disease remission in 6 months after surgery were compared between the two groups. Clinical indexes between the two groups were compared usingt test and Fisher’s exact test. Results The complications incidence of JI-LSG group patients was 33% （3/9）, which had no statistical difference with 22% （2/9） of LSG group （P=0.599）. At 6 months after surgery, the BMI loss and EWL% in JI-LSG group were （15±6） kg/m2 and （76±27）% respectively, which were significantly higher than （10±5） kg/m2 and （54±29）% of LSG group respectively （t=4.60, 4.18,P〈0.05）. The obesity-related complications of the two group patients all got significantly improved.Conclusions JI-LSG is not difficult to be performed, and has a good effect on obesity and metabolic diseases, but it is still in the early stage of application, so remains to be further investigated for its value.

关 键 词：肥胖症 腹腔镜胃袖状切除加空回肠侧侧吻合术 腹腔镜袖状胃切除术 治疗结果 

分 类 号：R656[医药卫生—外科学]