Sleeve Gastrectomy vs Roux-en-Y Gastric Bypass. Data from IFSO-European Chapter Center of Excellence Program
Sleeve Gastrectomy vs Roux-en-Y Gastric Bypass. Data from IFSO-European Chapter Center of Excellence Program
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DOI：
10.1007/s11695-016-2395-6
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发表时间：
2017-04-01
期刊：
影响因子：
2.9
通讯作者：
Kabir, Ali
中科院分区：
文献类型：
--
作者：
Melissas, John;Stavroulakis, Konstantinos;Kabir, Ali
本研究的目的是比较参与ifso欧洲分会卓越中心（COE）计划的机构进行的袖式胃切除术（SG）和Roux-en-Y胃旁路术（RYGBP）。方法自2010年1月该项目启动以来，截至2014年12月31日，6413例SGs和10622例RYGBPs作为主要手术，随访至少12个月，回顾性比较。结果2010 - 2015年，接受SG治疗的患者数量稳步增加。RYGBP术后早期（< 30 d）并发症发生率为3.02%，显著高于SG术后的2.12% （p = 0.0006）。只有2例患者（每组1例）在术后前30天死亡（SG组死亡率为0.016%，RYGBP-NS组死亡率为0.009%）。SG组103例患者（1.61%）和RYGBP组206例患者（1.94%）在减肥手术后30天出院后再次入院。在SG组再入院的患者中，75.72%再次手术，而RYGBP组为50.50% （p < 0.0001）。SG患者较重（BMI为44.93 vs 43.96 kg/m, p < 0.0001）。然而，RYGBP术后所有年份的超重减重百分比明显更好（60.36% vs 67.72%，第五年p = 0.002）。RYGBP术后第一年糖尿病、动脉高血压、血脂异常和睡眠呼吸暂停综合征的缓解率较好。结论两种手术均具有较低的并发症、死亡率、再入院率和再手术率。RYGBP术后头5年体重减轻效果较好。
Background The purpose of this study is to compare sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGBP) performed in Institutions participating in IFSO-European Chapter, Center of Excellence (COE) program.Methods Since the initiation of the program in January 2010, 6413 SGs and 10,622 RYGBPs performed as primary procedures by December 31, 2014, with at least 12-month follow-up, were retrospectively compared.Results There were steadily increasing numbers of patients underwent SG from 2010 to 2015. Early (< 30 days) postoperative complication rate of 3.02 % for RYGBP was significantly higher than 2.12 % seen after SG (p = 0.0006). Only two patients, one in each group, died in the first 30 postoperative days (0.016 % mortality for SG vs 0.009 % for RYGBP-NS). From SG group, 103 patients, 1.61 %, and 206 patients, 1.94 %, from RYGBP group required readmission following hospital discharge in the first 30 days following bariatric surgery-NS. From the readmitted patients in the SG group, 75.72 % were reoperated vs 50.50 % in the RYGBP group (p < 0.0001). SG patients were heavier (BMI 44.93 vs 43.96 kg/m(2), p < 0.0001). However, significantly better % excess weight loss were seen following RYGBP in all postoperative years (60.36 vs 67.72 %, p = 0.002 at fifth year). Better remission rates were seen for diabetes, arterial hypertension, dyslipidemia, and sleep apnea syndrome after RYGBP in the first postoperative year.Conclusions Both procedures were performed with very low complications, mortality, readmissions, and reoperations rate. Better weight loss was observed following RYGBP, the first five postoperative years.