腹腔镜单吻合口胃旁路术后的长期结局与生活质量：单中心经验

文献信息

中文摘要

背景： 在过去8年中，腹腔镜单吻合口胃旁路术（OAGB）已成为以色列治疗重度肥胖的主要减重手术之一。虽然文献中广泛报道了短期结局，但长期数据仍然有限。本研究总结了OAGB术后7年的结局和生活质量（QoL）。
方法： 对2016年1月至12月在Shamir医疗中心连续接受OAGB的患者进行了回顾性审查。数据来自前瞻性减重数据库并进行回顾性分析。所有患者均于2024年底参加了结构化电话访谈，平均随访时间为7年。根据术前和术后合并症、早期和晚期并发症、体重减轻、患者满意度以及使用减重分析与报告结局系统（BAROS）II评估的生活质量来评价手术结局。
结果： 最终分析纳入80例患者：55例女性（68.8%）和25例男性（31.2%），平均年龄44.3岁（范围：20-68）。术前平均体重为103.2 kg，平均BMI为40.9 kg/m²。平均手术时间为101.9分钟，平均住院时间为3.3天。30天内主要并发症发生率为5.1%。平均BMI在1.7年时降至28.1 kg/m²，并在整个随访期间保持稳定。平均%EWL在术后6个月时为80.2%，在7年时为74.6%。在术前有合并症的患者中，超过80%观察到2型糖尿病、高血压、阻塞性睡眠呼吸暂停和高脂血症得到缓解。生活质量在7年随访期间有所改善。
结论： OAGB是一种技术上简单且安全的手术，手术和住院时间短。它提供了持续的体重减轻、高合并症缓解率以及生活质量的长期改善。

英文摘要

BACKGROUND: Laparoscopic one-anastomosis gastric bypass (OAGB) has become one of the leading bariatric procedures for severe obesity in Israel over the past 8 years. While short-term outcomes have been widely reported in the literature, long-term data remain limited. This study summarizes 7-year outcomes and quality of life (QoL) following OAGB.
METHODS: A retrospective review was conducted of consecutive patients who underwent OAGB between January and December 2016 at Shamir Medical Center. Data were collected from a prospective bariatric database and analyzed retrospectively. All patients participated in a structured phone interview in late 2024, with a mean follow-up period of 7 years. Surgical outcomes were evaluated based on pre- and postoperative comorbidities, early and late complications, weight loss, patient satisfaction, and QoL using the Bariatric Analysis and Reporting Outcome System (BAROS) II.
RESULTS: Eighty patients were included in the final analysis: 55 females (68.8%) and 25 males (31.2%), with a mean age of 44.3 years (range: 20-68). The mean preoperative weight was 103.2 kg, and the mean BMI was 40.9 kg/m². The mean operative time was 101.9 minutes, and the average hospital stay was 3.3 days. Major complications within 30 days occurred in 5.1% of cases. The mean BMI decreased to 28.1 kg/m² at 1.7 years and remained stable throughout the follow-up period. Mean %EWL was 80.2% at 6 months and 74.6% at 7 years postoperatively. Resolution of type 2 diabetes, hypertension, obstructive sleep apnea, and hyperlipidemia was observed in over 80% of patients with preoperative comorbidities. QoL improved over the 7-year follow-up.
CONCLUSION: OAGB is a technically straightforward and safe procedure with short operative and hospitalization times. It provides sustained weight loss, high resolution of comorbidities, and long-term improvement in quality of life.