摘要
目的:探讨胃残腔大小对行腹腔镜胃袖状切除术(laparoscopic sleeve gastrectomy,LSG)的病态肥胖患者临床结局的影响。方法:2011年11月—2017年8月对96例病态肥胖患者依据胃残腔容积(即幽门到切除位置的距离)随机分成两组。一组为胃窦保留组(AP-LSG),自幽门到切除位置的距离为6 cm,共49例患者;另一组为胃窦切除组(AR-LSG),距离为2 cm,共47例患者。对两组患者进行至少12个月的术后随访,比较基本特征、超重百分比(%EWL)、体重指数(BMI)降低程度、并发症、死亡率及生活质量。结果:两组在年龄、性别、BMI、并存疾病等方面差异无统计学意义(P>0.05)。1例于术后30d死亡。两组术后并发症发生率差异无统计学意义(P>0.05)。术后6个月及12个月,两组患者体重均明显下降;12个月时,AR-LSG组体重下降较AP-LSG稍明显,但两组间差异无统计学意义(AP-LSG组%EWL为64.2%,AR-LSG组%EWL为67.6%,P>0.05);两组患者在并存疾病的治疗效果、生活质量评估方面差异亦无统计学意义(P>0.05)。结论:LSG手术过程中,无论是否保留较大的胃腔,都会产生明显体重减轻效果;保留胃窦及切除胃窦两种手术方式对于术后超重百分比(%EWL)的降低、并存疾病的治疗及生活质量改善等方面具有同样的效果。
Objective: To study the effect of gastric remnant cavity size on clinical outcome ofLSG patients by statistical analysis of randomized experimental data. Methods: From November 2011 to August 2017, 96 patients with morbidly obese were randomly divided into 2 groups accordingto the size of thegastric residual antrum (which depends on the distance frompyloric to resectionposition), one group was antralpresservation Group (AP-LSG), the distance from pyloric to resectionposition was 6cm, and 49 patients were in this group. The other group was the antralresection Group(AR-LSG), with a distance of 2cm, which composed of 47 patients. After at least 12 months ofpostoperative follow-up, the basic features, the percent excess weight lost (%EWL), reduction inbody mass index(BMI), complication, mortality, reoperation and quality of life were statistically evaluatedand analyzed. Results: The two groups were comparable in terms of age, sex, BMI andco-morbidities. Among them, only one mortality in 30-days postoperatively, and there was no significantdifference between the two groups in the complications rate or the early reoperation betweenthe 2 groups. Outcomesat 6 months and 12 months showed that the weight loss was obviousin both groups; At 12 months, the weight loss of AR-LSG group was slightly higher than that ofAP-LSG, but there was no significant difference between the two groups by statistical analysis(%EWL was 64.2%in the AP-LSG group, and %EWL was 67.6%in the AR-LSG Group); The resolution/improvement of co-morbidities, quality of life assessment and prevalence of integrated diseasewere similar. Conclusion: In the course of LSG, whether or not to retain the larger gastric cavity, itwill produce significant weight loss, the two procedures for the %EWL, the amelioration of co-morbiditiesand quality of life are equally effective.
作者
王键
王芳
WANGJian;WANGFang(Department of Gastroenterological Surgery,Yulin First Hospital,Yulin 719000,China;Department of Gastroenterology,Aftiliated Hospital of Yah'an University,Yan'an 716000,China)
出处
《中国现代普通外科进展》
CAS
2018年第10期770-773,777,共5页
Chinese Journal of Current Advances in General Surgery
关键词
减重手术
胃切除术
胃残腔
Bariatric surgery;Residual antrum;Sleeve gastrectomy