已提出腹腔镜Roux-en-Y胃旁路术(LRYGB)和腹腔镜垂直袖状胃切除术(LVSG)作为管理肥胖相关慢性疾病的经济有效策略。这项系统评价的目的是研究同行评价文献,有关比较LVSG和LRYGB手术的随机对照试验(RCTs)报告的术后非糖尿病合并症疾病缓解或改善。
RCT比较术后合并疾病的分辨率,如高血压,血脂异常,阻塞性睡眠呼吸暂停,关节和肌肉骨骼状况,胃食管反流病,纳入LVSG和LRYGB后的月经不调进行分析.这些研究选自PubMed,Medline,EMBASE,科学引文索引,当前内容,和Cochrane数据库,并报告了至少一种合并症的解决或改善。本工作是根据系统审查和荟萃分析(PRISMA)的首选报告项目进行的。将Jadad方法用于评估方法学质量。
在2005年至2015年期间进行了6项RCT,共695名患者(LVSGn=347,LRYGBn=348)报告了LVSG和LRYGB手术后共病的消退或改善。两种减肥方法在改善或解决这些合并症方面都提供了有效且几乎可比的结果。
这项对RCTs的系统评价表明,LVSG和LRYGB均可有效解决或改善肥胖患者术前的非糖尿病合并症。虽然目前的结果还没有定论,与LVSG相比,LRYGB在调节某些疾病如血脂异常和关节炎的缓解和/或改善方面可能提供更好的结果。
Laparoscopic Roux-en-Y gastric bypass (LRYGB) and laparoscopic vertical sleeve gastrectomy (LVSG) have been proposed as cost-effective strategies to manage obesity-related chronic disease. The aim of this systematic
review was to study the peer
review literature regarding postoperative nondiabetic comorbid disease resolution or improvement reported from randomized controlled trials (RCTs) comparing LVSG and LRYGB procedures.
RCTs comparing postoperative comorbid disease resolution such as hypertension, dyslipidemia, obstructive sleep apnea, joint and musculoskeletal conditions, gastroesophageal reflux disease, and menstrual irregularities following LVSG and LRYGB were included for analysis. The studies were selected from PubMed, Medline, EMBASE, Science Citation Index, Current Contents, and the Cochrane database and reported on at least one comorbidity resolution or improvement. The present work was undertaken according to the Preferred Reporting Items of Systematic Reviews and Meta-Analyses (PRISMA). The Jadad method for assessment of methodological quality was applied to the included studies.
Six RCTs performed between 2005 and 2015 involving a total of 695 patients (LVSG n = 347, LRYGB n = 348) reported on the resolution or improvement of comorbid disease following LVSG and LRYGB procedures. Both bariatric procedures provide effective and almost comparable results in improving or resolving these comorbidities.
This systematic
review of RCTs suggests that both LVSG and LRYGB are effective in resolving or improving preoperative nondiabetic comorbid diseases in obese patients. While results are not conclusive at this time, LRYGB may provide superior results compared to LVSG in mediating the remission and/or improvement in some conditions such as dyslipidemia and arthritis.