单吻合口十二指肠回肠旁路联合袖状胃切除术与腹腔镜袖状胃切除术治疗重度肥胖患者的近期疗效比较
Single-anastomosis duodenoileal bypass with sleeve gastrectomy versus laparoscopic sleeve gastrectomy in the treatment of severe obesity:a one-year efficacy analysis
朱冬梓 1杨珵璨 1马帅 1王文越 1王兵1
作者信息
- 1. 上海交通大学医学院附属第九人民医院普外一科,上海 200011
- 折叠
摘要
目的 比较单吻合口十二指肠回肠旁路联合袖状胃切除术(SADI-S)与腹腔镜下袖状胃切除术(LSG)治疗重度肥胖患者的安全性和近期疗效.方法 回顾性分析2020年1月至2023年1月于上海交通大学医学院附属第九人民医院普外科接受SADI-S治疗的46例重度肥胖患者和同期接受LSG治疗的110例重度肥胖患者的临床资料,比较手术安全性和术后近期的临床疗效.结果 LSG手术时间少于 SADI-S[(70.2±6.2)min 比(122.4±9.8)min,t=38.436,P＜0.001],两组术中出血量和术后住院时间差异均无统计学意义[(26.6±8.9)ml 比(28.2±9.9)ml,t=0.920,P=0.359;(3.6±1.7)d 比(3.3±1.0)d,t=1.362,P=0.175].术后近期SADI-S组减重效果优于LSG组,差异具有统计学意义(体重减轻百分比:29.0％±11.6％比21.5％±10.0％,t=4.068,P＜0.001),糖尿病和高脂血症完全缓解率高于LSG组,差异具有统计学意义(72.7％比40.5％,x2=9.458,P=0.002;93.2％比60.4％,x2=15.934,P＜0.001).术后近期SADI-S组贫血和血清铁缺乏发生率高于LSG组,差异具有统计学意义(19.6％比5.4％,x2=5.896,P=0.015;39.1％比10.9％,x2=16.632,P＜0.001).结论 SADI-S和LSG均能有效治疗重度肥胖及其相关代谢疾病,SADI-S对肥胖、2型糖尿病和高脂血症的疗效优于LSG,但是术后出现营养不良并发症的发生率较高.
Abstract
Objective To study the safety and short-term efficacy of single-anastomosis duodenoileal bypass with sleeve gastrectomy(SADI-S)and laparoscopic sleeve gastrectomy(LSG)in the treatment of severe obesity patients.Methods Retrospective analysis of the clinical data from 46 severely obese patients undergoing SADI-S treatment at the Department of General Surgery,Shanghai Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine from Jan 2020 to Jan 2023,vs.110 severely obese patients who receiving LSG during the same period,were made to compare surgical safety and clinical efficacy short-term after surgery.Results The LSG surgery time was lower than that of SADI-S[(122.4±9.8)min vs.(70.2±6.2)min,t=38.436,P＜0.001],and there was no statistically significant difference in intraoperative blood loss and postoperative hospital stay between the two groups.[(26.6± 8.9)ml vs.(28.2±9.9)ml,t=0.920,P=0.359;(3.6±1.7)d vs.(3.3±1.0)d,t=1.362,P=0.175]In the immediate postoperative period,both groups of patients showed significant improvements in obesity and metabolic disorders,and the difference was statistically significan t(TWL％:29.0％±11.6％vs.21.5％±10.0％,t=4.068,P＜0.001).and In SADI-s group rates of complete remission of diabetes mellitus and hyperlipidemia were higher than those in the LSG group,and the difference was statistically significant(72.7％vs.40.5％,x2=9.458,P=0.002;93.2％vs.60.4％,x2=15.934,P＜0.001).The incidence of anemia and serum iron deficiency in the SADI-S group was higher than that in the LSG group in the immediate postoperative period.(19.6％vs.5.4％,x2=5.896,P=0.015;39.1％vs.10.9％,x2=16.632,P＜0.001)Conclusion Both SADI-S and LSG can effectively treat severe obesity and its related metabolic diseases.SADI-S is more effective than LSG in treating obesity,type 2 diabetes and hyperlipidemia,while the incidence of malnutrition complications after surgery is higher.
关键词
肥胖症,病态/胃切除术/腹腔镜Key words
Obesity,morbid/Gastrectomy/Laparoscopy引用本文复制引用
基金项目
上海申康医院发展中心临床三年行动计划资助(SHDC2020CR1017B)
出版年
2024
NETL
NSTL
维普
万方数据