[1]尹刚 张能维 朱斌 阿民布和 闫巍 廉东坡 樊庆 刘晨 杜德晓 张东东 张振 张雁凯 宫轲*.腹腔镜Roux-enY胃旁路术与腹腔镜胃袖状切除术 治疗肥胖病的对比研究[J].中国微创外科杂志,2015,15(6):487-496.
　Yin Gang,Zhang Nengwei,Zhu Bin,et al.A Comparison of Roux-en-Y Gastric Bypass and Laparoscopic Sleeve Gastrectomy for Severe Obesity[J].Chinese Journal of Minimally Invasive Surgery,2015,15(6):487-496.
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腹腔镜Roux-enY胃旁路术与腹腔镜胃袖状切除术 治疗肥胖病的对比研究()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
15
期数:
2015年6期
页码:
487-496
栏目:
临床论著
出版日期:
2015-06-20

文章信息/Info

Title:
A Comparison of Roux-en-Y Gastric Bypass and Laparoscopic Sleeve Gastrectomy for Severe Obesity
作者:
尹刚 张能维 朱斌 阿民布和 闫巍 廉东坡 樊庆 刘晨 杜德晓 张东东 张振 张雁凯 宫轲*
首都医科大学附属北京世纪坛医院普通外科，北京100038
Author(s):
Yin Gang;  Zhang Nengwei;  Zhu Bin;  et al.
Department of General Surgery, Beijing Shijitan Hospital of Capital Medical University, Beijing 100038, China
关键词:
肥胖病; 减重手术; 腹腔镜RouxenY胃旁路术; 腹腔镜胃袖状切除术
Keywords:
Obesity; Bariatric surgery; Laparoscopic RouxenY gastric bypass; Laparoscopic sleeve gastrectomy
分类号:
R656.6+1
文献标志码:
A
摘要:
目的比较腹腔镜RouxenY胃旁路术（laparoscopic RouxenY gastric bypass，LRYGB）与腹腔镜胃袖状切除术（laparoscopic sleeve gastrectomy，LSG）治疗肥胖病的疗效。方法2012年1月~2014年1月符合入组条件的肥胖病49例，术前BMI 38.85±6.40（32.01~58.64），其中42例（86%）合并2型糖尿病，37例（76%）合并高甘油三酯血症（hypertriglyceridemia，HTG）。根据患者选择的手术方式分为LRYGB组（n=26）和LSG组（n=23），将临床资料进行对比研究。结果2组均成功实施手术。LRYGB组手术时间明显长于LSG组［（108.8±16.1）min vs. （90.9±24.8）min，t=3031，P=0.004］。术后随访12~28个月，平均16个月。49例术后12个月BMI 29.75±3.46，与术前相比明显下降(t=14135，P=0000）；术后多余体重减除率（EWL%）80.06%±14.28%（51.00%~120.00%）。42例合并2型糖尿病者术后空腹血糖和糖化血红蛋白较术前明显下降［（9.23±3.40）mmol/L vs. （8.00±1.94）mmol/L，t=3.168，P=0.003；6.22%±163% vs. 543%±0.93%，t=7.212，P=0.000］；37例合并HTG患者术后甘油三酯水平较术前亦下降［（2.49±0.77）mmol/L vs. （164±0.68）mmol/L，t=5.202，P=0.000］。2组体重减轻、降糖、降脂效果无明显差异（P均>0.05）。结论LRYGB与LSG治疗肥胖病是安全有效的，对合并2型糖尿病及高甘油三酯血症也有较好的疗效。LSG操作相对简单，符合胃肠道生理，值得优先选择。
Abstract:
ObjectiveTo compare the effects of laparoscopic Roux-en-Y gastric bypass (LRYGB) and laparoscopic sleeve gastrectomy (LSG) for the treatment of the obesity patients. MethodsA total of 49 patients suffering from severe obesity were enrolled in this study in our hospital from January 2012 to January 2014. The mean body mass index (BMI) ranged 32.01-58.64 (38.85±6.40) before surgery. Among them, 42 (86%) patients had type 2 diabetes (DM2) and 37 (76%) patients had hypertriglyceridemia (HTG). The patients were divided into LRYGB group (n=26) or LSG group (n=23) based on patients’ selection. Clinical data of the two group were compared. ResultsAll the patients underwent surgery successfully. The average operating time in the LRYGB group was significantly longer than the LSG group ［(108.8±16.1) min vs. (90.9±24.8) min, t=3031, P=0.004)］. The patients were followed up for 12-28 months, with an average period of 16 months. The BMI of all the patients was 29.75±3.46 at 12 months after surgery, which was decreased significantly than before the surgery (t=14.135, P=0000). The mean excess weight loss (EWL%) was 80.06%±14.28% (51.00%-120.00%) at 12 months after surgery. The average levels of fasting blood sugar (FBS) and glycosylated hemoglobin (HbAlc) after surgery in 42 obesity patients with DM2 were lower than those before surgery ［(9.23±3.40) mmol/L vs. (8.00±1.94) mmol/L, t=3.168, P=0.003；6.22%±1.63% vs. 5.43%±0.93%, t=7.212, P=0.000］. The mean serum triglyceridein in 37 obesity patients with HTG was decreased after surgery as compared to that before surgery ［(2.49±0.77) mmol/L vs. (1.64±0.68) mmol/L, t=5.202, P=0.000］. There were no significant difference in the body weight loss, decrease of fasting blood sugar and serum triglyceride between the two groups (P>005).ConclusionsLRYGB and LSG are safe and effective to treat the patients suffered from obesity, including patients with type 2 diabetes or hypertriglyceridemia. We recommend LSG as preferable choice of the surgical procedure considering simple performance as well as no change of digestive system.

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备注/Memo

备注/Memo:
*通讯作者，E-mail：gongke6688@yahoo.com
更新日期/Last Update: 2015-06-20