腹腔镜袖状胃切除术与胃旁路术治疗肥胖症的临床疗效对比  

Comparison on the clinical efficacy between laparoscopic sleeve gastrectomy and laparoscopic gastric bypass for obesity

作　　者：李士军 刘家盛[1] 罗建飞[1] LI Shijun;LIU Jiasheng;LUO Jianfei(Dept.of Gastrointestinal Surgery,Renmin Hospital of Wuhan University,Wuhan 430060,Hubei,China)

机构地区：[1]武汉大学人民医院胃肠外科,湖北武汉430060

出　　处：《武汉大学学报（医学版）》2023年第3期356-359,367,共5页Medical Journal of Wuhan University

摘　　要：目的:比较腹腔镜袖状胃切除术(LSG)及腹腔镜Roux-en-Y胃旁路术(LRYGB)治疗肥胖症及其合并症的临床疗效。方法:纳入2017年1月至2018年12月在武汉大学人民医院接受LSG及LRYGB治疗的肥胖症患者的临床资料,比较术后1年半、3年的手术安全性、多余体重下降百分比(%EWL)、术后体质量指数(BMI)等指标。结果:共纳入92例患者(62例LSG,30例LRYGB),平均年龄(31.0±10.9)岁,围手术期BMI平均为(45.2±5.4)kg/m^(2)。随访3年,LSG组与LRYGB组%EWL>50%相比差异不明显(82.2%vs 82.1%);主要并发症发生率LRYGB明显高于LSG(16.7%vs 4.8%,P=0.005)。胃食管反流病(GERD)发病率在LSG组升高,而在LRYGB组降低。结论:在减重方面LSG不比LRYGB差,3年随访期间手术相关并发症的风险降低,但GERD发生率在LSG组中增加而LRYGB组降低。Objective:To compare the efficacy between the laparoscopic sleeve gastrectomy(LSG)and laparoscopic Roux-en-Y gastric bypass(LRYGB)for obesity and its comorbidity.Methods:The clinical data of patients with obesity who received LSG and LRYGB from January 2017 to December 2018 in Renmin Hospital of Wuhan University were collected,and the safety,percentage of excess weight loss(%EWL),body weight index(BMI)and other indicators after 1.5 and 3 years post-operation were compared.Results:A total of 92 patients(62 LSG and 30 LRYGB)were enrolled.The average age was(31.0±10.9)years old.The average perioperative BMI was(45.2±5.4)kg/m^(2).After 3 years follow-up,there was no significant difference in%EWL>50%(82.2%)of LSG as compared with LRYGB(82.1%).The incidence of major complications of LRYGB(16.7%)was significantly higher than LSG(4.8%,P=0.005).Gastroesophageal reflux disease(GERD)incidence increased in LSG group and decreased in LRYGB group.Conclusion:LSG was found non-inferior to LRYGB with respect to weight loss and was associated with lower risk of major complications during a 3-year follow-up.But the incidence of GERD increased in LSG group and decreased in LRYGB group.

关 键 词：减重手术 肥胖症 袖状胃切除术 胃旁路术 

分 类 号：R589.2[医药卫生—内分泌] R656.61[医药卫生—内科学]