肥胖和腹腔镜下全胃垂直扩张

M. Wiren, A. Thorell
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摘要

随着“肥胖的流行”,世界范围内减肥手术的数量也在增加。现在有几种不同的程序;每种方法都有特定的优点和缺点。主要由于后者,新的程序正在不断发展。最近描述的技术之一是腹腔镜全胃垂直伸展术(LTGVP)。据报道,LTGVP与短期(18个月)的减肥效果和并发症发生率有关(1)。此外,由于对昂贵的一次性设备的需求有限,LTGVP在经济上是一种有吸引力的替代方案。然而,到目前为止,关于LTGVP对肥胖相关并发症以及长期体重发展的影响的数据还不够。在《J mini surgery Sci》的一期中,Golpaie等人报道了15例LTGVP术后6周术前BMI为44 kg/m2的患者血脂和胰岛素敏感性变化的数据(2)。虽然没有给出太多关于手术技术、营养摄入或术后过程的数据,但这是关于LTGVP术后重要生化参数变化的第一个信息。因此,报告增加了有关后处理效果的信息。然而,由于缺乏适当的对照组,在短期内体重减轻的程度相同,因此难以评估该手术的具体代谢机制。我们期待更多关于长期效果的数据,以便确定该手术治疗病态肥胖患者的适应症。
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Obesity and Laparoscopic Total Gastric Vertical Plication
In parallel with “epidemic of obesity”, the number of bariatric surgical procedures is increasing worldwide. Several different procedures are now available; each procedure has specific advantages and shortcomings. Mainly due to the latter, new procedures are being developed continuously. One of the most recently described techniques is Laparoscopic Total Gastric Vertical Plication (LTGVP). LTGVP has been reported to be associated with promising short-time (18 months) results in terms of weight loss and complication rates (1). Also, due to the limited need of expensive disposable equipment, LTGVP is an attractive alternative economically. However, data on effects of LTGVP on obesity-associated co-morbidity as well as long-term weight development are insufficient so far. In one of the issues of “J Minim Surg Sci”, Golpaie et al. reported data on changes in blood lipid profile and insulin sensitivity in 15 patients with a preoperative BMI of 44 kg/m2, 6 weeks after LTGVP (2). Although not much data on surgical technique used, nutritional intake or postoperative course was given, this represents the first information regarding changes in important biochemical parameters after LTGVP. As such, the report adds information regarding postprocess effects. However, lack of the proper control group with the same degree of weight loss during this short term period makes the specific metabolic mechanisms of the procedure difficult to evaluate. We are looking forward to more data regarding the long-term effects in order to define the indication of this procedure for treatment of patients with morbid obesity.
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