Comparative Efficacy and Safety of Laparoscopic Greater Curvature Plication and Laparoscopic Sleeve Gastrectomy: A Meta-analysis
Comparative Efficacy and Safety of Laparoscopic Greater Curvature Plication and Laparoscopic Sleeve Gastrectomy: A Meta-analysis
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DOI：
10.1007/s11695-015-1842-0
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发表时间：
2015-08
期刊：
影响因子：
2.9
通讯作者：
Yu Tang;Shanhong Tang;Sanyuan Hu
中科院分区：
文献类型：
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作者：
Yu Tang;Shanhong Tang;Sanyuan Hu
腹腔镜大曲率扩胃术（LGCP）被认为是从微创腹腔镜袖式胃切除术（LSG）发展而来的。在目前的荟萃分析中，我们比较了这两种治疗方法的有效性和安全性。从数据库建立到2015年4月，我们检索了PubMed、Embase和Cochrane Library。使用Review Manager 5.3软件评估超重减重（%EWL）、肥胖相关合并症的解决、不良事件、手术时间和术后住院时间。以下4项研究符合纳入条件：1项随机对照试验和3项非随机对照试验，涉及299例患者。我们的荟萃分析显示，在随访3个月（Z= 2.26,p= 0.02）、6个月（Z= 4.49,p< 0.00001）和12个月（Z= 6.99,p< 0.00001）时，LSG术后EWL百分比显著高于LGCP。两种方法对糖尿病的缓解效果差异无统计学意义（p= 0.66）。根据汇总数据，LGCP与LSG的不良事件相关（p= 0.01）较多。两组手术时间（p= 0.54）和术后住院时间（p= 0.44）具有可比性。LGCP不仅在有效减肥方面不如LSG，而且在安全性方面也不如LSG。
Laparoscopic greater curvature plication (LGCP) is considered to have evolved from less invasive laparoscopic sleeve gastrectomy (LSG). In the present meta-analysis, we compared these two procedures in terms of efficacy and safety. We searched PubMed, Embase, and the Cochrane Library from database inception until April 2015. Excess weight loss (%EWL), resolution of obesity-related comorbidities, adverse events, operation time, and postoperative hospital stay were evaluated using the software Review Manager 5.3. The following four studies were eligible for inclusion: one randomized controlled trial and three non-randomized controlled trials involving 299 patients. Our meta-analysis demonstrated a significantly greater %EWL after LSG than LGCP at the follow-up time points of 3 months (Z= 2.26,p= 0.02), 6 months (Z= 4.49,p< 0.00001), and 12 months (Z= 6.99,p< 0.00001). The difference in the resolution of diabetes mellitus between these two approaches did not reach statistical significance (p= 0.66). According to the pooled data, LGCP was associated with more adverse events than was LSG (p= 0.01). The operation time (p= 0.54) and postoperative hospital stay (p= 0.44) were comparable between the two groups. LGCP is inferior to LSG not only in terms of providing effective weight loss but also in terms of safety.