重建腹病患者的结果和管理
Pourya Medhati1, Omnia S Saleh1, Abdelrahman Nimeri2,3,1
1Laboratory for Surgical and Metabolic Research, Brigham and Women's Hospital (Medhati, Saleh, Nimeri, Sheu, Tavakkoli), Brigham and Women's Hospital, Boston, MA.
Journal of the American College of Surgeons
|February 29, 2024
概括
重复增加体重是患者在代谢和减肥手术 (MBS) 后返回减肥护理的主要驱动因素. 袖子胃切除术患者更经常需要MBS修订,而Roux-En-Y胃绕道患者从GLP-1RA等药物中获益更多.
科学领域:
- 代谢和腹部手术 代谢和腹部手术
- 患者的治疗结果.
- 重量管理重量管理
背景情况:
- 在代谢和减肥手术 (MBS) 后,终身随访对于监测患者的结果和营养状况至关重要.
- 许多患者停止了与MBS团队的例行随访,需要对重新参与的研究.
- 了解失去了随访和后续治疗的原因对于改善长期MBS护理至关重要.
研究的目的:
- 调查MBS患者在失去后续治疗后寻求减肥护理的主要原因.
- 为了确定这些患者接收的后续治疗.
- 为了比较不同MBS手术的结果和干预措施 (袖子胃切除术,Roux-En-Y胃绕道,可调节的胃带).
主要方法:
- 400名在2018年7月至2022年12月期间停止MBS随访和恢复护理的患者进行了回顾性队列研究.
- 包括有史经过袖子胃切除术 (SG),Roux-En-Y胃绕道 (RYGB) 和可调节的胃带带 (AGB) 的患者.
- 分析了介绍和后续干预的原因,包括MBS修订和内镜手术.
主要成果:
- 在所有MBS类型中,重复增加体重是恢复护理的最常见原因 (81.2%在SG,62.7%在RYGB,65.2%在AGB).
- 袖子胃切除术患者的MBS修复手术率 (16.9%) 与Roux-En-Y胃绕道患者 (5.8%) 相比较高.
- 鲁克斯-恩-Y胃绕道术患者更有可能接受内镜干预 (17.5%) 并对抗肥胖药物,特别是GLP-1受体激动剂,表现出更好的反应.
结论:
- 重复增加体重是患者在随访中断后寻求重新参与MBS护理的主要原因.
- 袖子胃切除术与更高的MBS修订需求有关,而Roux-En-Y胃绕道患者更频繁地接受内镜干预.
- 抗肥胖药物,特别是GLP-1受体激动剂,在经过Roux-En-Y胃绕道术的患者中似乎更有效.
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