摘要
目的:探讨分阶段实施腹腔镜袖状胃切除术(LSG)及十二指肠回肠Ω转位术(DIOS)对于外科治疗病态肥胖症的可行性和意义。方法:对2012年收治的病态肥胖合并合并2型糖尿病、高血脂女性患者1例,分阶段于同年4月13日实施LSG,随访11个月后于2013年3月12日实施DIOS,分析其手术前后肥胖与相关指标的变化及并发症情况。结果:患者LSG术前、DIOS术前、随访2年,体质量指数(47.6、42.3、31.0 kg/m^2)、体质量(140、125、92 kg)、糖化血红蛋白水平(6.3%、5.7%、5.0%),血甘油三酯水平(2.54、1.87、1.26 g/L),总胆固醇水平(2.42、1.89、1.68 g/L)均呈下降表现,且随访2年时患者完全脱离降糖药物治疗。围术期及术后2年内,未发现吻合口瘘、营养不良、脱发、倾倒综合征及胆汁反流等近、远期并发症。结论:LSG联合DIOS具备分阶式减肥组合术式特性,有望在临床上开展。
Objective： To investigate the possibility and applicability of the staged operation of laparoscopic sleeve gastrectomy （LSG） and duodeno-ileal omega switch （DIOS） in surgical treatment of morbid obesity. Methods： A female morbidly obese patient with concomitant type 2 diabetes and hyperlipidemia admitted in 2012 underwent staged operation of LSG on 13th April of the same year, and then DIOS on 12th March 2013 after 11-month follow-up. The changes in obesity indexes and other relevant parameters of the patient before and after operation as well as the complications were analyzed.Results： The relevant data of the patient at pre-LSG, pre-DIOS and 2 years after DIOS, indicated the body mass index （47.6, 42.3, and 31.0 kg/m2）, body weight （140, 125, and 92 kg）, glycosylated hemoglobin （6.3%, 5.7%, and 5.0%）, blood triglyceride （2.54, 1.87 and 1.26 g/L） and total cholesterol （2.42, 1.89 and 1.68 g/L） all showed a decreasing pattern, moreover, the patient completely eliminated dependency on glucose lowering drugs at two years after operation. During perioperative and 2-year postoperative period, no short- or long-term complications such as anastomotic leakage, malnutrition, alopecia, dump syndrome or biliary reflux occurred. Conclusion： LSG associated with DIOS owns the features of stepwise bariatric operation, and seems to be promising in clinical practice
出处
《中国普通外科杂志》
CAS
CSCD
北大核心
2015年第12期1737-1741,共5页
China Journal of General Surgery
基金
湖北省武汉市人力资源与社会保障局2012年度留学人员科技活动择优资助项目[2012(258)]
湖北省武汉市科技局对外科技合作与交流计划资助项目(201171034321)
