评估袖状胃切除术或Roux-en-Y胃旁路术后治疗成功预测因素的队列研究

IF 0.5 4区 医学 Q4 SURGERY
J. Grandt, Johannes Chang, A. Türler, C. Jansen, R. Schierwagen, Tatjana Schröder, M. Praktiknjo, C. Strassburg, U. Spengler, J. Trebicka, L. Gluud
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引用次数: 0

摘要

. 背景:减肥手术对一些患者是一种有效的治疗方法,但有些患者可能无法达到足够的体重减轻。因此,我们评估了足够减重的预测因子,定义为超重减重≥50% (EWL)。方法:回顾性队列研究,包括接受袖式胃切除术(SG)或roux - y胃旁路手术(RYGB)的患者,随访12个月。结果:共纳入170例患者,其中女性81.2%,年龄42岁,2型糖尿病(T2D) 19.4%,体重指数(BMI) 49.4 kg/ m2。手术类型为SG(71.2%)或RYGB(28.8%)。手术后,中位BMI降至34.9 (30.0-40.5)kg/ m2。EWL中位数为57.7(41.6-69.7)。术前体重减轻与%EWL无相关性(P=0.25)。获得治疗成功的患者的基线中位BMI较低,为48.0 (IQR, 42.9-51.6) kg/ m2,而未获得治疗成功的患者的基线中位BMI为52.0 (IQR, 48.0 - 58.5) kg/ m2,基线BMI与EWL %相关(P<0.001)。性别、年龄和手术方法不能预测治疗成功。在logistic回归分析中,基线BMI和T2D是唯一的预测因子。结论:较低的基线BMI和没有T2D预测治疗成功率和EWL %。RYGB和SG表现同样好,但RYBG中T2D患者的比例更高,这可能影响了结果。需要进一步的研究来评估这些发现。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Cohort study evaluating predictors of therapeutic success after sleeve gastrectomy or Roux-en-Y gastric bypass
. Background: Bariatric surgery is an effective treatment for several patients, but some may not achieve sufficient weight loss. We therefore evaluated predictors of adequate weight loss defined as ≥ 50% excess weight loss (EWL). Methods: Retrospective cohort study including patients who underwent sleeve gastrectomy (SG) or Roux-Y-gastric bypass (RYGB) followed for 12 months. Results: A total of 170 patients [81.2% female, age 42 years, 19.4% type 2 diabetes (T2D), body mass index (BMI) 49.4 kg/m 2 ] were included. Type of surgery was SG (71.2%) or RYGB (28.8%). After surgery, the median BMI decreased to 34.9 (30.0–40.5) kg/m 2 . The median %EWL was 57.7 (41.6–69.7). Pre-operative weight loss was not associated with %EWL (P=0.25). Patients who achieved therapeutic success had a lower baseline median BMI of 48.0 (IQR, 42.9–51.6) kg/m 2 whereas those who did not had a median BMI of 52.0 (IQR, 48.0–58.5) kg/m 2 and the baseline BMI was correlated with the %EWL (P<0.001). Gender, age, and surgical method did not predict therapeutic success. The baseline BMI and T2D were the only predictors in logistic regression analysis. Conclusions: A lower baseline BMI and absence of T2D predicted therapeutic success and %EWL. RYGB and SG performed equally well, but the proportion of patients with T2D was higher in RYBG what may have influenced the outcome. Additional research is needed to evaluate the findings.
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