腹腔镜胃袖套状切除术与Roux-en-Y胃肠短路术治疗2型糖尿病前瞻性研究Meta分析

目的 外科治疗2型糖尿病（T2DM）对于血糖控制有良好效果，腹腔镜胃袖套状切除术（LSG）与腹腔镜Roux-en-Y胃肠短路术（LRYGB）是常采用的两种术式，本次研究将系统评价该两种术式对T2DM的疗效及其临床应用价值。方法 通过Pubmed、Embase、Springerlink、万方和CNKI数据库文献搜索LSG与LRYGB两种术式治疗肥胖的随机对照试验研究，文献检索时间截止至2012年4月。采用RevMan 5.1软件对纳入文献进行Meta分析。结果 共纳入6篇前瞻性研究文献，Meta分析的结果显示两术式对术后血糖缓解率、HbA1c、血糖下降幅度、体重指数和体重下降的影响无统计学差异（P>0.10）；LSG术后额外体重丢失低于LRYGB（P=0.04），并效应值-14.17（95%CI：-27.44，-0.90）。结论 LSG与LRYGB在对T2DM的体重和血糖的控制效果相当，提示LSG可作为外科治疗T2DM的优先考虑术式之一。

Laparoscopic sleeve gastrectomy and Roux-en-Y gastro-intestinal bypass for the treatment of type 2 diabetes: a Meta-analysis of prospective research

Objective Surgical procedure is effective treatment for management of T2DM.This study aimed to evaluate and compare two regular surgical operations:primary laparoscopic sleeve gastrectomy(LSG) and laparoscopic Roux-en-Y gastric bypass(LRYGB) for the treatment of T2DM.Methods Systematic literature search of MEDLINE,EMBASE,Springerlink,Wanfang and CNKI database(to April 2012) was performed.Only prospective trials comparing LSG and LRYGB,were included.Data were analyzed by RevMan 5.1 from the Cochrane Collaboration.Results Six trails,with a total of 463 patients were included and analyzed.Meta-analysis showed there were no significant differences regarding the remission of diabetes,HbA1c,change of glucose,BMI and weight lost,between LSG and LRYGB(P>0.10).Excess weight loss was lower in LSG than LRYGB(P=0.04),and the pooled estimate of mean was-14.17(95%CI:-27.44,-0.90).Conclusion LSG and LRYGB are same effective operations in controls of weight,lipids and glucose,which suggests LSG should be primary procedure for treatment of T2DM.