腹腔镜下管状胃切除术和可调节胃绑带术对肥胖患者的影响

目的 比较腹腔镜下管状胃切除术（LSG）和腹腔镜下可调节胃绑带术（LAGB）两种手术方式对于肥胖患者的减肥效果以及对于伴随肥胖而产生的2型糖尿病（T2DM）患者的改善情况,探讨何种方式具有优势.方法 检索PubMed、Embase、万方、知网数据库从2000年1月1日-2012年8月17日公开发表的关于LSG和LAGB的文献,采用RevMan 5.0统计软件进行分析,比较通过这两种手术方式后6个月和12个月患者体重的减轻程度以及对T2DM的改善情况,通过选择计算相对危险度（95％ CI）作为效应尺度指标来评估这两种方式的有效性.结果 11篇关于腹腔镜下管状胃切除术和腹腔镜下可调节胃绑带术的比较的研究符合要求,共计1 004例患者.Meta分析显示,对于LAGB,6个月的平均的促进体重减轻（EWL）（年）百分比是33.9％,12个月的EWL（年）百分比是37.8％.对于LSG,6个月的平均EWL为50.6％,而12个月的EWL则达到了51.8％.68例T2DM患者中有42例（61.8％）在经过LAGB手术后病情得到改善或治愈,80例行LSG的T2DM患者中有66例（82.5％）得到改善或治愈.结论 相对于LAGB,LSG是一个更加有效的方式,在改善病态肥胖和T2DM上具有更加良好的效果.

Comparison between laparoscopic sleeve gastrectomy and laparoscopic adjustable gastric banding for morbid obesity

Objective To compare the effects of laparoscopic sleeve gastrectomy （LSG） and laparoscopic adjustable gastric banding （LAGB） on excess weight loss （EWL） and type 2 diabetes mellitus （T2DM）,then to evaluate which one is superior to the other.Methods PubMed,Embase,Wanfang Database and HowNet database were searched for publications concerning LAGB and LSG from 2000 to 2012,with the last search on August 17,2012.EWL and T2DM improvement over 6 and 12 months were pooled and compared by meta-analysis.Odds ratios （ORs） and mean differences were calculated with 95％ confidence intervals （ CI）.Results Eleven studies involving 1004 patients in total met the inclusion criteria.The mean percentage EWL for LAGB was 33.9％ after 6 months in studies and 37.8％ after 12 months; for LSG,EWL was 50.6％ after 6 months and 51.8％ after 12 months,T2DM was improved in 42 of 68 patients （61.8％） after LAGB and 66 of 80 （82.5％） after LSG.Conclusions LSG is more effective than LAGB in morbid obesity,with higher percentage EWL and greater improvement in T2DM.