Comparison of Laparoscopic Sleeve Gastrectomy and Roux-en-Y Gastric Bypassfor Metabolic Syndrome with Nonalcoholic Fatty Liver
Objective To compare the efficacy of laparoscopic sleeve gastrectomy(LSG)and Roux-en-Y gastric bypass(LRYGB)in the treatment of metabolic syndrome(MS)with nonalcoholic fatty liver disease(NAFLD).Methods A total of 200 patients with MS and NAFLD in Central Hospital of Jiaozuo Coal Industry(Group)Co.,LTD from April 2021 to October 2022 were prospectively selected and divided into LRYGB group and LSG group by random number table method,100 cases in each group.Surgical indicators,postoperative complications,glucose metabolism indexes[fasting blood glucose level(FBG),glycosylated hemoglobin level(HbA1c),insulin resistance index(HOMA-IR)],lipid metabolism indexes[total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C)and low-density lipoprotein cholesterol(LDL-C),triglyceride(TG)],weight loss[body mass,body mass index(BMI)],NAFLD disease controls before and after 6,12 months of operation were compared between two groups.Results The amount of blood loss in LSG group was less than that in LRYGB group,operation time,the time of liquid intake,the time of exhaust and the time of hospitalization were shorter than those in LRYGB group(P＜0.05).The incidence of postoperative complications in LSG group was lower than that in LRYGB group(P＜0.05).After 6,12 months of operation,the levels of HbA1c,FBG,HOMA-IR,TC,TG,LDL-C,body mass and BMI in LSG group in both groups were gradually decreased,the level of HDL-C was gradually increased compared with before surgery(P＜0.05),but there were no significant differences in above indicators between the two groups(P＞0.05).After 6,12 months of operation,the condition of NAFLD was reduced compared with before operation,but there was no statistical significance in the control of NAFLD between the two groups(P＞0.05).Conclusion LSG and LRYGB are both reliable treatment options for patients with MS and NAFLD,both of which can improve glucose metabolism indexes,lipid metabolism indexes,weight loss,and effectively control the disease of NAFLD.However,compared with LRYGB,LSG can reduce intraoperative blood loss,shorten operation time,reduce the incidence of postoperative complications,promote rapid postoperative recovery,and has more advantages in the treatment of patients with MS and NAFLD.
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