尼森袖式胃切除术:5年随访结果。

IF 3.5 3区 医学 Q1 SURGERY
Natalia Savvala M.D. , Mailis Amico Ph.D. , Saaddedine Joumaa M.D. , Audrey Jaussent , Marta Silvestri M.D. , Patrick Lefebvre M.D. , Arvin Khamajeet M.D. , Marie Christine Picot M.D. , Florence Galtier M.D. , David Nocca M.D., Ph.D.
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引用次数: 0

摘要

背景:Nissen套筒胃切除术是两种著名手术技术(竖直套筒胃切除术和Nissen胃底复制术)相结合的一种新型减肥手术。它被认为是一种预防袖式胃切除术(SG)的主要缺点——胃食管反流病(GERD)的方法,同时保留了SG在减肥和缓解肥胖相关合并症方面的优势。目的:本研究的目的是介绍Nissen套管胃切除术的长期(5年)随访结果,包括体重减轻、GERD及其他合并症的进展情况以及并发症发生率。单位:法国蒙彼利埃大学医院。方法:这是对2018年1月至2019年2月期间接受尼森套管胃切除术作为一线减肥手术的患者的前瞻性分析。对随访期间未进行进一步手术的患者进行亚组分析。结果:共有144例患者接受了Nissen套管胃切除术:在调整排除标准后,133例患者构成了初始研究人群,其中81.9%的患者在5年时完成了体重和胃食管反流临床症状结局的随访。平均总减重率(TWL%)为22(±12.3)%,平均超额减重率(EWL%)为59.4%(±34.2%)%。在63例术前有GERD临床症状的患者中,我们观察到5年临床缓解率为85.5%;然而,只有25例患者在5年内进行了胃镜检查。累计短期和长期再手术率为8.1%,死亡率为零。结论:Nissen套管胃切除术获得了令人满意的长期TWL%,并显著改善了合并症,特别是关于胃反流的发生率。再手术并发症发生率低。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Nissen sleeve gastrectomy: 5-year follow-up results

Background

Nissen sleeve gastrectomy is a new bariatric procedure based on the combination of 2 well-known surgical techniques (vertical sleeve gastrectomy and Nissen fundoplication). It was conceived as a means to prevent the major drawback of the sleeve gastrectomy (SG), the gastroesophageal reflux disease (GERD), while preserving the advantages of SG in terms of weight loss, and remission of obesity-related comorbidities.

Objectives

The objectives of this study are to present the long-term (5 years) follow-up results on weight loss, evolution of GERD and other comorbidities, and the complication rate of the Nissen sleeve gastrectomy.

Setting

Montpellier University Hospital, France.

Methods

This is a prospective analysis of patients who underwent Nissen sleeve gastrectomy as a first-line bariatric procedure between January 2018 and February 2019. A subgroup analysis of patients with no further surgery during follow-up was also performed.

Results

A total of 144 patients underwent Nissen sleeve gastrectomy: After adjusting for exclusion criteria, 133 patients comprised the initial study population, 81.9% of whom had complete follow-up for weight and GERD clinical symptom outcomes at 5 years. The mean total weight loss (TWL%) was 22 (±12.3)% and the mean excess weight loss percentage (EWL%) was 59.4% (±34.2)%. Of the 63 patients with preoperative clinical symptoms of GERD, we observed an 85.5% 5-year clinical remission rate; however, only 25 patients had a gastroscopy at 5 years. The cumulative short- and long-term reoperation rate was 8.1% and the mortality rate was zero.

Conclusions

The Nissen sleeve gastrectomy achieves a satisfactory long-term TWL% and a significant improvement in comorbidities, particularly regarding the incidence of GERD. The rate of complications requiring surgical reoperation is low.
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来源期刊
CiteScore
6.70
自引率
12.90%
发文量
570
审稿时长
56 days
期刊介绍: Surgery for Obesity and Related Diseases (SOARD), The Official Journal of the American Society for Metabolic and Bariatric Surgery (ASMBS) and the Brazilian Society for Bariatric Surgery, is an international journal devoted to the publication of peer-reviewed manuscripts of the highest quality with objective data regarding techniques for the treatment of severe obesity. Articles document the effects of surgically induced weight loss on obesity physiological, psychiatric and social co-morbidities.
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