腹腔镜下袖式胃切除术不同切除线治疗病态肥胖症的近远期临床疗效观察  

Short - and long-term clinical efficacy of laparoscopic sleeve gastrectomy with different resection lines formorbid-obesepatients

作　　者：夫尔多斯·阿马努拉 黄海军 马尚智 秦鹏 王金龙[3] Aman Ferdawis;Huang Haijun;Ma Shangzhi;Qin Peng;Wang Jinlong(General Surgery Center for Gastrointestinal Hernia Surgery,Karamay Central Hospital of Xinjiang,Karamay Xinjiang Province 834000,China;Department of General Surgery,Karamay Central Hospital of Xinjiang,Karamay Xinjiang Province 834000,China;Department of General Surgery,Shufu County People's Hospital,Shufu County Kashgar Xinjiang Province 844000,China)

机构地区：[1]新疆克拉玛依市中心医院普外中心胃肠疝外科,新疆克拉玛依834000 [2]新疆喀什地区疏附县人民医院普外科,新疆喀什疏附县844000 [3]新疆克拉玛依市中心医院普外科,新疆克拉玛依834000

出　　处：《中华普外科手术学杂志（电子版）》2023年第1期32-35,共4页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

基　　金：新疆克拉玛依市中心医院普外中心胃肠疝外科, 新疆克拉玛依834000;新疆喀什地区疏附县人民医院普外科 ,新疆喀什疏附县844000;新疆克拉玛依市中心医院普外科, 新疆克拉玛依834000。

摘　　要：目的探讨腹腔镜下袖式胃切除术(LSG)不同切除线治疗病态肥胖症的近远期临床疗效。方法回顾性分析2018年8月至2020年8月确诊并行LSG治疗的病态肥胖症患者200例,根据切除线到幽门以上胃窦保留距离不同分为两组,8cm组(距幽门5~8cm处,容积90~110ml,n=80例)和4cm组(距幽门2~4cm处,容积60~80ml,n=120例)。采用SPSS18.0软件进行统计分析,围手术期各项指标、术后效果指标总重量损失(TWL%)和过度减肥百分比(EWL%)等以(x±s)表示,采用独立样本t检验;减重疗效判断采用秩和检验;术后并发症等采用卡方检验。P<0.05表示差异有统计学意义。结果两组患者围手术期各项指标比较差异无统计学意义(P>0.05)。两组患者术后TWL%、EWL%均显著升高,术后6~24个月,8cm组患者各随访时期TWL%、EWL%均高于4cm组(P<0.05)。8cm组患者术后24个月减重总有效率高于4cm组(P<0.05),但患者术后胃食管反流病(GERD)发生率高于4cm组(P=0.016)。结论LSG是一种有效治疗病态肥胖症的手术方法,近期疗效良好;增大切除线到幽门的距离可提高体重减轻比,但会增加胃食管反流病的发生。ObjectiveTo investigate the near and long term clinical efficacy of laparoscopic sleeve gastrectomy(LSG)with different resection lines in the treatment of morpathological obesity.Methods A retrospective analysis was conducted on 200 mordantly obese patients diagnosed with LSG from August 2018 to August 2020,and they were divided into two groups according to the different retention distances from the resection line to the antrum above the pylorus:the 8 cm group(5~8 cm away from the pylorus,volume 90~110 ml,n=80 cases) and the 4cm group(2~4 cm away from the pylorus,volume 60~80 ml,n=120 cases).SPSS18.0 software was used for statistical analysis.Perioperative indicators,postoperative effect indicators,total weight loss(TWL%)and percentage of excessive weight loss(EWL%)were expressed as(x±s),and independent sample t test was used.The efficacy of weight loss was evaluated by rank sum test.Chi-square test was used for postoperative complications.P<0.05 was indicated statistically significant difference.ResultsThere was no significant difference in perioperative indexes between the two groups(P>0.05).Postoperative TWL% and EWL% were significantly increased in both groups,and 6-24 months after surgery,TWL%and EWL%in the 8cm group were higher than those in the 4cm group in each follow-up period(P<0.05).The total effective rate of weight loss 24 months after surgery in 8 cm group was higher than that in 4cm group(P<0.05),but the incidence of postoperative gastroesophageal reflux disease(CERD)was higher than that in 4cm group(P=0.016).Conclusion LSG is an effective surgical method for the treatment of morbid obesity with good short-term efficacy.Increasing the distance from the resection line to the pylorus increased the ratio of weight loss but increased the incidence of gastroesophageal reflux disease.

关 键 词：肥胖症 骨胃切除术 腹腔镜 疗效比较研究 

分 类 号：R735.2[医药卫生—肿瘤]