腹腔镜袖状胃切除术(LSG)是日本最常见的减肥手术,这是国家健康保险唯一涵盖的此类程序。日本减肥手术的长期费用尚未分析。我们旨在评估LSG对2型糖尿病(T2DM)患者药物治疗费用的长期影响。
我们回顾性分析了2007年至2018年间在我们机构接受LSG治疗的230例肥胖和T2DM患者的数据。临床病理数据包括年龄,性别,体重指数(BMI),以及T2DM的术前和术后用药,高血压,和血脂异常。然后我们计算了T2DM的药物治疗费用,高血压,和LSG前后血脂异常;我们评估了这些肥胖相关疾病的缓解率。
230例接受LSG的患者的术前中位体重和BMI分别为115kg和40.6kg/m2。2型糖尿病患者每个月的术前药物治疗费用,高血压,血脂异常为3795日元(0-40285日元),¥3269(¥0-14577),和¥1428(¥0-19464)。手术后,所有这些疾病的药物治疗费用中位数为零。2型糖尿病的缓解率,高血压,LSG后5年血脂异常为82.8%,50%,和43.8%,分别。在日本,LSG手术的费用相当于4.75年治疗T2DM和高血压的中位药物费用.
从长远来看,日本的LSG对肥胖和T2DM患者在身体和成本方面都有效。
Laparoscopic sleeve gastrectomy (LSG) is the most common type of bariatric surgery in Japan, and it is the only such procedure covered by national health insurance. The long-term cost of bariatric surgery in Japan has not yet been analyzed. We aimed to evaluate the long-term impact of LSG on the drug treatment costs of patients with type 2 diabetes mellitus (T2DM).
We retrospectively analyzed data from 230 patients who had undergone LSG at our institution for their obesity and T2DM between 2007 and 2018. The clinicopathological data included age, sex, body mass index (BMI), as well as preoperative and postoperative medications for T2DM, hypertension, and dyslipidemia. We then calculated the drug treatment costs for T2DM, hypertension, and dyslipidemia before and after LSG; and we evaluated the remission rates of these obesity-related diseases.
The median preoperative body weight and BMI of the 230 patients who underwent LSG were 115 kg and 40.6 kg/m2, respectively. Preoperative drug treatment costs per month per patient for T2DM, hypertension, and dyslipidemia were ¥3795 (¥0-40285), ¥3269 (¥0-14577), and ¥1428 (¥0-19464). Post-operation, the median drug treatment costs for all these diseases became nil. The remission rates of T2DM, hypertension, and dyslipidemia 5 years after LSG were 82.8%, 50%, and 43.8%, respectively. In Japan, the cost of an LSG operation corresponds to 4.75 years of median drug costs to treat T2DM and hypertension.
In the long term, LSG in Japan is effective both physically and cost-wise for patients with obesity and T2DM.