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.
作者
李士军
刘家盛
罗建飞
LI Shijun;LIU Jiasheng;LUO Jianfei(Dept.of Gastrointestinal Surgery,Renmin Hospital of Wuhan University,Wuhan 430060,Hubei,China)
出处
《武汉大学学报（医学版）》
CAS
2023年第3期356-359,367,共5页
Medical Journal of Wuhan University
关键词
减重手术
肥胖症
袖状胃切除术
胃旁路术
Bariatric Surgery
Obesity
Sleeve Gastrectomy
Roux-En-Y Gastric Bypass
作者简介
李士军,男,1982-,医学硕士,主治医师,从事胃肠道肿瘤及肥胖症外科治疗相关研究,E-mail:dr.lishijun@whu.edu.cn;通讯作者:罗建飞,男,1972-,医学博士,主任医师,从事胃肠道肿瘤、肥胖及2型糖尿病的外科治疗相关研究,E-mail:afei099@163.com。
