重视SADI-S手术全流程质量控制

Emphasis on the whole clinical process quality control of single anastomosis duodenal-ileal bypass with sleeve gastrectomy

近年来,腹腔镜袖状胃切除术(LSG)成为开展最多的治疗病态肥胖和相关代谢疾病的手术术式,但部分患者临床疗效仍不理想。单吻合口十二指肠-回肠旁路联合袖状胃切除术(SADI-S)作为简化的胆胰分流并十二指肠转位术(BPD-DS)术式,在控制肥胖和糖尿病等代谢疾病方面显示出良好效果,得到了业内广泛认可和推荐。但SADI-S手术的临床疗效尚缺少前瞻性多中心研究数据支持,以及统一认可的手术质量标准。因此严格把握手术适应症、建立SADI-S手术的质量控制体系尤为重要和迫切。本文结合近期国内外SADI-S手术疗效、风险等质控问题,以及笔者单位临床经验和相关研究进展,论述了SADI-S手术质量控制的若干问题。

In recent years,laparoscopic sleeve gastrectomy(LSG)has become the most commonly performed surgical procedure for the treatment of morbid obesity and related metabolic diseases.However,the clinical outcomes for some patients remain suboptimal.The single anastomosis duodeno-ileal bypass with sleeve gastrectomy(SADI-S),as a simplified version of the biliopancreatic diversion with duodenal switch(BPD-DS),has shown good efficacy in controlling obesity and diabetes-related metabolic diseases,gaining wide recognition and recommendation in the field.Nevertheless,the clinical efficacy of SADI-S lacks support from prospective multicenter research data and universally accepted surgical quality standards.Therefore,it is crucial to strictly define surgical indications and establish a quality control system for SADI-S procedures.This paper discusses the quality control issues of SADI-S surgery,including its recent clinical efficacy and risks,based on domestic and international studies,as well as the clinical experience and research progress of the author's institution.