A 7-Year Clinical Audit of 1107 Cases Comparing Sleeve Gastrectomy, Roux-En-Y Gastric Bypass, and Mini-Gastric Bypass, to Determine an Effective and Safe Bariatric and Metabolic Procedure
A 7-Year Clinical Audit of 1107 Cases Comparing Sleeve Gastrectomy, Roux-En-Y Gastric Bypass, and Mini-Gastric Bypass, to Determine an Effective and Safe Bariatric and Metabolic Procedure
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DOI：
10.1007/s11695-015-1869-2
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发表时间：
2016-05-01
期刊：
影响因子：
2.9
通讯作者：
Sharma, Rajni
中科院分区：
文献类型：
--
作者：
Jammu, Gurvinder S.;Sharma, Rajni
肥胖症的流行正在席卷发达国家和印度等发展中国家。我们介绍了我们7年的经验，腹腔镜袖状胃切除术（LSG），Roux-en-Y胃旁路术（RYGB）和微型胃旁路术（MGB），以确定一种有效和安全的减肥和代谢程序。这项研究是对前瞻性收集的473例MGB，339例LSG和295例RYGB的减肥数据库的分析。LSG的死亡率为2.1%，RYGB为0.3%，MGB为0%。LSG的泄漏最高（1.5%），其次是RYGB（0.3%），MGB为零。在MGB系列中，胆汁反流的发生率<1%。持续性呕吐仅见于LSG。LSG组体重恢复率为14.2%，RYGB组为8.5%，MGB组为0%.低白蛋白血症在LSG中是最小的，在RYGB中是2.0%，在MGB中是13.1%（在旁路> 250 cm的早期患者中）。以下合并症的解决：血脂异常、2型糖尿病（T2 D）、高血压和过量体重减轻百分比（%EWL）在MGB中最大。GERD以LSG最多（9.8%），其次为RYGB（1.7%），MGB最少（0.6%），RYGB和MGB均以限制和吸收不良为作用原理，但MGB在技术简便性、有效性、可逆性和可逆性方面优于RYGB。MGB组死亡率为0。在MGB中，%EWL和合并症的消退非常显著。根据这次审计，我们建议MGB是有效和安全的程序，为患者谁是在服用他们的补充剂合规。LSG可以在不依从的患者和准备接受体重恢复的患者中进行。
The epidemic of obesity is engulfing developed as well as developing countries like India. We present our 7-year experience with laparoscopic sleeve gastrectomy (LSG), Roux-en-Y gastric bypass (RYGB), and mini-gastric bypass (MGB) to determine an effective and safe bariatric and metabolic procedure.The study is an analysis of a prospectively collected bariatric database of 473 MGBs, 339 LSGs, and 295 RYGBs.Mortality rate was 2.1 % in LSG, 0.3 % in RYGB, and 0 % in MGB. Leaks were highest in LSG (1.5 %), followed by RYGB (0.3 %), and zero in MGB. Bile reflux was seen in < 1 % in the MGB series. Persistent vomiting was seen only in LSG. Weight regain was 14.2 % in LSG, 8.5 % in RYGB, but 0 % in MGB. Hypoalbuminemia was minimal in LSG, 2.0 % in RYGB, and 13.1 % in MGB (in earlier patients where bypass was > 250 cm). The following resolution of comorbidities: dyslipidemia, type 2 diabetes (T2D), hypertension, and percent excess weight loss (%EWL) was maximum in MGB. GERD was maximum in LSG (9.8 %), followed by RYGB (1.7 %), and minimal in MGB (0.6 %).RYGB and MGB act on the principle of restriction and malabsorption, but MGB superseded RYGB in its technical ease, efficacy, revisibility, and reversibility. Mortality was zero in MGB. %EWL and resolution of comorbidities were highly significant in MGB. Based on this audit, we suggest that MGB is the effective and safe procedure for patients who are compliant in taking their supplements. LSG may be done in non-compliant patients and those ready to accept weight regain.