病态肥胖患者手术并发症的评估,两种腹腔镜减肥手术方法(腹腔镜胃旁路术、腹腔镜袖式胃切除术)的选择

A. Pazouki, S. Mokhber, S. Riazi, P. Alibeigi, M. Abdolhosseini, F. Jesmi
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引用次数: 2

摘要

背景:2005年,全世界宣布肥胖率为3.96亿,在过去20年里翻了一番(与1985年相比)。肥胖与一系列合并症和后果有很强的相关性。虽然许多模块,包括行为方法和药物,都提出了一些短期不可靠的方法来减少和控制病态肥胖患者的体重,但只有5 - 10%的体重减轻得到了实现,而且通常会随着时间的推移而恢复,而减肥手术的成功率为50 - 75%。目的:本回顾性研究试图通过为期一年的随访,监测转至德黑兰某知名中心的病态肥胖患者在LRYGB和LSG后的体重减轻情况。材料和方法:参与者是根据美国国立卫生研究院(NIH)指南选择的,该指南指示BMI > 40 kg/ m2,或者BMI > 35 kg/ m2,此外还有合并症和非手术控制体重的失败尝试。在术后1个月、3个月、6个月和12个月进行随访,收集体重减轻、BMI和并发症的信息,以及超重体重减轻的百分比(EWL%)。失败的百分比计算为EWL% < 25的患者占一年内手术患者总数的比例。结果:所有术后随访患者的BMI和体重均有显著下降(P值均< 0.0001),两种研究方法在这方面的参数无显著差异。结论:综上所述,LRYGB和LSG不仅在目前的研究中,而且在目前的大多数研究中都是值得优先考虑的。然而,相关研究迫切需要确认这种减肥手术的优先选择或改进,以尽可能减少并发症。
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Assessment of Surgical Complications in Morbid Obese Patients, The Candidates for 2 Methods of Laparoscopic Bariatric Surgery (Laparoscopic Gastric Bypass, Laparoscopic Sleeve Gastrectomy)
Background: In 2005, obesity rate was declared 396 million worldwide, which has been doubled in the last 20 years (compared with 1985). Obesity has a strong correlation with a pool of comorbidities and consequences. Although many modules, including behavioural approach and medications have presented particular short-term unreliable methods to reduce and control the body weight in morbid obesity, only 5 - 10% of weight loss was achieved, which is usually regained overtime, compared with 50 - 75% success rate in bariatric surgery. Objectives: This retrospective study tried to monitor weight loss after LRYGB and LSG in morbid obese patients referred to a known center in Tehran through a one-year follow up. Materials and Methods: Participants were selected regarding the U.S. National Institute of Health (NIH) guidelines, which indicates BMI > 40 kg/m 2 alone, or BMI > 35 kg/m 2 in addition to comorbidities and failure of non-surgical attempts to control their weight. They were visited at points of one, three, six, and 12 months postoperatively to collect information about weight loss, BMI, and complications in addition to percent excess weight loss (EWL%). The percentage of failure was computed to the proportion of patients who had EWL% < 25 to the total number of operated patients in a year. Results: Significant decrease in BMI and weight were achieved in all postoperative visits (for all of them, P value < 0.0001), while no significant difference was found in which the parameters between two studied procedures were in this regard. Conclusions: To sum up, LRYGB and LSG deserve an overall preference not only in current study, but also in the majority of performances up to now. Nevertheless it is urgent the relevant studies to confirm the preference or improve this kind of bariatric surgery in order to diminish complications as far as possible.
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