由于腹内脂肪量,超肥胖(SSO)患者的减肥手术仍然是一个持续的挑战,较高的肝脏体积和现有的合并症。SSO患者的一种方便程序是一次吻合胃旁路术(OAGB)。这项研究的目的是比较接受OAGB的SSO患者与腹腔镜袖状胃切除术(LSG)的预后。
我们回顾性回顾了2008年至2020年间在我们机构接受OAGB和LSG的SSO患者的数据。主要终点包括手术后12、24和36个月的总体体重减轻百分比和BMI减轻百分比。次要终点是围手术期并发症,程序长度,住院时间和合并症的结果。
本研究包括243例患者。93例患者接受LSG,150例接受OAGB。在评估的任何时间点,OAGB后患者的体重减轻大于LSG患者,而OAGB的手术长度明显短于LSG(81.4vs.92.1分钟,p值<0.001)。此外,OAGB组的平均住院时间较短(3.4vs.4.5天,p值<0.001)。LSG组有更严重的并发症(Clavien-Dindo≥3a)(11.8%vs2.7%,p值=0.005)。
在这项回顾性分析中,在SSO患者的体重减轻方面,OAGB优于LSG。与LSG相比,OAGB后的手术时间和住院时间更短,严重并发症也更少。因此,OAGB可以被认为是SSO患者的安全有效的治疗方式。
Bariatric surgery in super-super-obese (
SSO) patients remains a continuous challenge due to intraabdominal fat masses, higher liver volume and existing comorbidities. A convenient procedure in
SSO patients is one anastomosis gastric bypass (OAGB). The aim of this study was to compare the outcome of SSO patients undergoing OAGB in comparison to laparoscopic sleeve gastrectomy (LSG).
We retrospectively reviewed data from
SSO patients who underwent OAGB and LSG in our institution between 2008 and 2020. Primary endpoints included percentage total body weight loss and percentage BMI loss at 12, 24, and 36 months after the operation. Secondary endpoints were perioperative complications, procedure length, length of hospital stay and outcome of comorbidities.
243 patients were included in this study. 93 patients underwent LSG and 150 underwent OAGB. At any of the time points evaluated, weight loss in patients after OAGB was greater than in LSG patients, while procedure length was significantly shorter for OAGB than LSG (81.4 vs. 92.1 min, p-value < 0.001). Additionally, mean length of hospital stay was shorter in the OAGB group (3.4 vs. 4.5 days, p-value < 0.001). There were more severe complications (Clavien-Dindo ≥ 3a) in the LSG group (11.8% vs 2.7%, p-value = 0.005).
In this retrospective analysis, OAGB was superior to LSG in terms of weight loss in
SSO patients. Procedure length and hospital stay were shorter after OAGB in comparison to LSG and there were fewer severe complications. OAGB can therefore be regarded a safe and effective treatment modality for
SSO patients.