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スリーブから胃バイパスへの転換: 217人の患者を対象とした多施設試験
Georges Kaoukabani1, Amin Andalib2, Romulo Lind3
1Department of Surgery, Mayo Clinic, Rochester, MN, USA.
まとめ
スリーブ胃切除を ルックス・エン・Y胃バイパスに変換すると,GERDの症状が効果的に解消され,体重減少が促進されます. しかし,GERDのために改訂された患者は,重量再発のために改訂された患者と比較して,より遅い再手術を経験しました.
科学分野:
- 腹部外科
- 胃腸内科
- 手術による改修
背景:
- スリーブ胃切除 (SG) からRoux-en-Y胃バイパス (RYGB) に変換することは,胃食道逆流症 (GERD) と体重再発のために行われます.
- SGからRYGBの見直しの結果に関する既存の研究は矛盾しており,長期的なデータが不足しています.
研究 の 目的:
- SGをRYGBに変換した後のGERD症状の解消と追加の体重減少を評価する.
- GERDと重度の再発を比較する
主な方法:
- 前向きに維持された多中心性減量手術のデータを遡及的に分析する.
- 患者はGSからRYGBへの変換のためにGERDまたは体重再発の指標グループに分けられました.
- 分析されたアウトカムには,全体重減少,GERD解消,栄養状態,および合併症 (再手術,再入院) が含まれていた.
主要な成果:
- GERD患者は124人,体重が重かった患者は93人,体重が重かったグループは最初のBMIが高かった.
- 比較可能な体重減少が両群で修正後達成された (GERD: 13%,体重: 16%).
- GERD患者の75%以上が1年後に症状の解消を経験したが,GERD患者では4年以上にわたって再手術が遅かった (14%対4%).
結論:
- SGからRYGBへの変換は,GERD解像度とさらなる体重減少に有効です.
- 効果的ですが,GERDのリビジョンは,体重再発のリビジョンと比較して,より悪い長期的な臨床結果,特に遅い再手術の増加と関連しています.
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