腹腔镜袖状胃切除术治疗重度肥胖症的临床疗效

Efficacy of Laparoscopic Sleeve Gastrectomy for Morbid Obesity

目的探讨腹腔镜下袖状胃切除术对重度肥胖症(体重指数BMI>35)的临床疗效。方法 2008年8月～2011年5月,对30例重度肥胖症患者实施腹腔镜袖状胃切除术,全身麻醉,腹腔镜下超声刀离断胃周韧带,术中电子胃镜指引下,使用Endo-GIA紧贴胃大弯侧行袖状胃切除。术后随访1年,观察BMI及超重体重下降百分比(excess weight loss,EWL%)的变化情况。结果 30例手术顺利,无术中并发症及中转开腹。术后1年体重指数(28.7±5.3)较术前(35.2±7.2)降低(t=3.98,P<0.001)。术后1年随访EWL%,根据Reinhold等制定的标准,效果极佳24例(80%)(EWL%76%～90%),良好6例(20%)(EWL%55%～73%)。结论腹腔镜袖状胃切除术治疗重度肥胖症近期疗效明显,长期疗效有待进一步观察。

Objective To investigate the efficacy of laparoscopic sleeve gastrectomy （LSG） for morbid obesity （ BMI 〉 35 ）. Methods Since August 2008 to May 2011, we performed LSG on 30 patients with morbid obesity. Under general anesthesia, with an ultrasonic scalpel, we cut the perigastric ligaments; and then under the guidance by electronic gastroscopy, we performed sleeve gastrectomy with Endo-GIA along the greater curvature of the stomach. The patients were followed up for one year, their BMI and excess weight loss （ EWL% ） were detected regularly during the period. Results The procedure was completed in all the patients without intraoperative complications or conversion to open surgery. One year after the operation, the mean BMI of the patients significantly dropped from 35.2 ± 7.2 to 28.7 ±5.3 （t = 3.98, P 〈 0. 001 ）. According to the Reinhold＇ s criteria, 24 of the patients （80%） achieved excellent outcomes （ EWL% ： 76% - 90% ） , and the others （20%） were good （ EWL% ： 55% - 73% ）. Conclusions LSG is effective in short term for morbid obesity. Further study is necessary to determine its long-term outcomes.