腹腔镜胃袖状切除联合单吻合口十二指肠回肠旁路术治疗肥胖症及肥胖相关代谢病17例疗效分析

目的 探讨腹腔镜胃袖状切除联合单吻合口十二指肠回肠旁路术（SADI-S）治疗肥胖症及肥胖相关性代谢病的临床疗效。 方法 回顾性分析2018年10月至2019年8月吉林大学中日联谊医院减重与代谢外科行腹腔镜SADI-S治疗的17例肥胖症及肥胖相关性代谢病病人的临床资料。观察分析手术对体重、BMI、血压、空腹血糖、糖化血红蛋白、血脂及尿酸的影响。结果 17例病人均完成腹腔镜SADI-S,无严重并发症发生,无中转开腹及围术期死亡。病人的体重、BMI、腰围、多余体重百分比在术后3、6个月均显著下降,差异均具有统计学意义（P＜0.05）。术后3、6个月,2型糖尿病完全缓解率分别为71.4%（5/7）、85.7%（6/7）,高血压缓解率分别为0、6.7%（1/15）,高甘油三酯血症完全缓解率分别为36.4%（4/11）、72.7%（8/11）,高胆固醇血症完全缓解率分别为66.7%（4/6）、83.3%（5/6）,高低密度脂蛋白血症完全缓解率分别为42.9%（3/7）、42.9%（3/7）,高尿酸血症完全缓解率分别为38.5%（5/13）、61.5%（8/13）。结论 腹腔镜SADI-S对肥胖症及肥胖相关性代谢病在术后短期具有显著的治疗效果,但长期安全性及有效性有待进一步随访观察。

Effect analysis of laparoscopic single-anastomosis duodenal-jejunal bypass with sleeve gastrectomy on the treatment of obesity and obesity-related metabolic diseases

Effect analysis of laparoscopic single-anastomosis duodenal-jejunal bypass with sleeve gastrectomy on the treatment of obesity and obesity-related metabolic diseases JIANG Tao. Department of Bariatric and Metabolic Surgery,China-Japan Union Hospital,Jilin University,Changchun 130033,China
Abstract Objective To investigate the clinical effect of laparoscopic single-anastomosis duodenal-jejunal bypass with sleeve gastrectomy（SADI-S） on the treatment of patients with obesity and obesity-related metabolic diseases. Methods The clinical data of 17 patients who were treated with SADI-S in China-Japan Union Hospital of Jilin University from October 2018 to August 2019 were analyzed retrospectively. The effects of surgery on body mass,body mass index,blood pressure,fasting blood glucose,glycosylated hemoglobin,blood lipids and uric acid were analyzed. Results A total of 17 patients were treated successfully with SADI-S without serious complications,conversion to open surgery and perioperative death. The weight,BMI and waist circumference of the patients decreased significantly at 3 months and 6 months after operation (P<0.05). At 3 months and 6 months after operation,the complete remission rate of type 2 diabetes was 71.4%（5/7） and 85.7%（6/7）; the complete remission rate of hypertension was 0（0/15） and 6.7%（1/15）; the complete remission rate of hypertriglyceridemia was 36.4%（4/11） and 72.7%（8/11）; the complete remission rate of hypercholesterolemia was 66.7%（4/6） and 83.3%（5/6）; the complete remission rate of hyper-LDL was 42.9%（3/7） and 42.9%（3/7）; the complete remission rate of hyperuricemia was 38.5%（5/13） and 61.5%（8/13）. Conclusion Laparoscopic SADI-S has a significant short-term effect on patients with obesity and obesity-related metabolic diseases,but its long-term safety and efficacy need to be further followed up.