Laparoscopic bariatric surgery improves candidacy in morbidly obese patients awaiting transplantation
Laparoscopic bariatric surgery improves candidacy in morbidly obese patients awaiting transplantation
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DOI：
10.1016/j.soard.2007.12.009
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发表时间：
2008-03-01
影响因子：
3.1
通讯作者：
Posselt, Andrew M.
中科院分区：
文献类型：
--
作者：
Takata, Mark C.;Campos, Guilherme M.;Posselt, Andrew M.
背景：在一所大学的三级转诊中心，评估安全性和。腹腔镜Roux-en-Y胃旁路术（LRYGB）治疗终末期肾病（ESRD）患者和腹腔镜袖状胃切除术（LSG）治疗肝硬化或终末期肺病（ESLD）患者的疗效;并确定这些手术是否有助于患者成为更好的移植候选人。方法：对因病态肥胖而不适合移植的终末期器官衰竭患者进行了回顾性分析，这些患者接受了LRYGB或LSG。前瞻性收集的数据包括人口统计学资料，手术细节，并发症，过度体重减轻的百分比，术后实验室数据，和移植candidation.Results的状态：在15例患者中，7例ESRD进行LRYGB和6例肝硬化和2例ESLD进行LSG。2例患者发生并发症（均为肝硬化）;无患者死亡。平均随访时间为12.4个月，≥ 9个月时体重过度减轻的平均百分比为61%（ESRD），33%（肝硬化）和61.5%（ESLD）。所有患者的肥胖相关合并症均改善或消退。术后2：9个月时，所有3组的血清白蛋白和其他营养参数均与术前水平相似。在最近的随访中，15例患者中有14例（93%）达到了我们机构的体重指数限值，正在等待移植。这项初步研究的结果提供了初步证据，表明LRYGB用于ESRD患者和LSG用于肝硬化或ESLD患者是安全的，耐受性良好，并提高其移植的候选性。(Surg肥胖相关疾病2008;4：159-165。(C)2008年美国代谢和减肥外科学会。All rights reserved.
Background: To evaluate, at a university tertiary referral center, the safety and. efficacy of laparoscopic Roux-en-Y gastric bypass (LRYGB) in patients with end-stage renal disease (ESRD) and laparoscopic sleeve gastrectomy (LSG) in patients with cirrhosis or end-stage lung disease (ESLD); and to determine whether these procedures help patients become better candidates for transplantation.Methods: A retrospective review was performed of selected patients with end-stage organ failure who were not eligible for transplantation because of morbid obesity who Underwent LRYGB or LSG. The prospectively collected data included demographics, operative details, complications, percentage of excess weight loss, postoperative laboratory data, and status of transplant candidacy.Results: Of the 15 patients, 7 with ESRD underwent LRYGB and 6 with cirrhosis and 2 with ESLD underwent LSG. Complications developed in 2 patients (both with cirrhosis); no patient died. The mean follow-up was 12.4 months, and the mean percentage of excess weight loss at >= 9 months was 61% (ESRD), 33% (cirrhosis), and 61.5% (ESLD). Obesity-associated co-morbidities improved or resolved in all patients. Serum albumin and other nutritional parameters at 2:9 months after surgery were similar to the preoperative levels in all 3 groups. At the most recent follow-tip visit, 14 (93%) of 15 patients had reached our institution's body mass index limit for transplantation and were awaiting transplantation I patient with ESLD underwent successful lung transplant.Conclusion: The results of this pilot study have provided preliminary evidence that LRYGB in patients with ESRD and LSG in patients with cirrhosis or ESLD is safe, well-tolerated, and improves their candidacy for transplantation. (Surg Obes Relat Dis 2008;4:159-165.) (C) 2008 American Society for Metabolic and Bariatric Surgery. All rights reserved.