腹腔镜胃袖状切除术对肥胖合并代谢性疾病的治疗效果分析

Effect of laparoscopic sleeve gastrectomy on obesity complicated with metabolic diseases

目的 探讨腹腔镜胃袖状切除术(laparoscopic sleeve gastrectomy, LSG)对肥胖及其合并代谢性疾病的疗效。方法 回顾性分析武汉大学中南医院肥胖症与代谢病外科中心于2017年8月至2021年3月期间接受LSG的439例单纯性肥胖或肥胖合并代谢性疾病病人的临床资料。分析手术对体重改变、多余体重减少百分比(percent excess weight loss,%EWL)、糖脂代谢和肝功能的影响。结果 所有病人均顺利完成腹腔镜手术,无中转开腹。术后1、3、12、24、36个月时%EWL分别为(45.00±36.84)%、(72.17±28.25)%、(109.82±43.27)%、(101.62±34.35)%、(93.77±33.22)%。随访最长时间为36个月,未出现严重后遗症。术后1、3、12、24、36个月肥胖合并代谢异常如血糖、血脂、尿酸、丙氨酸转氨酶、天冬氨酸转氨酶等生化指标得到明显改善(P<0.05)。结论 LSG对肥胖症病人减重效果确切、安全,并且对肥胖相关代谢性疾病有显著的疗效。

Objective To explore the effect of laparoscopic sleeve gastrectomy(LSG) on obesity and metabolic diseases.Methods From August 2017 to March 2021 at the Bariatric and Metabolic Diseases Surgery Center of Zhongnan Hospital of Wuhan University, clinical data were retrospectively reviewed for 439 patients with simple obesity or obesity complicated with metabolic diseases undergoing LSG. Surgical effects on body weight change, percentage of excess weight loss(%EWL), glucolipid metabolism and liver function were analyzed.Results All laparoscopies were successfully completed without any conversion into laparotomy. The values of % EWL at 1, 3, 12, 24 and 36 months post-operation were(45.00±36.84) %,(72.17±28.25) %,(109.82±43.27) %,(101.62±34.35) % and(93.77±33.22) % respectively. The longest postoperative follow-up period was 36 months without serious sequelae. Blood biochemical examinations at 1/3/12/24/36 months post-operation indicated that obesity complicated with metabolic abnormalities such as blood glucose, blood lipid, uric acid, alanine aminotransferase, aspartate aminotransferase and other biochemical parameters significantly improved(P<0.05).Conclusion Both effective and safe for weight loss in obese patients, LSG has significant effect on obesity-related metabolic diseases.