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中华肥胖与代谢病电子杂志

中华肥胖与代谢病电子杂志 ›› 2017, Vol. 03 ›› Issue (03) : 143 -149. doi: 10.3877/cma.j.issn.2095-9605.2017.03.007

所属专题： 文献；

循证医学

袖状胃切除术和Roux-en-Y胃旁路术治疗肥胖症疗效的Meta分析
张若蹊1, 刘殿刚1,†(), 张超1, 高翔1, 李非1   
  1. 1. 100053　北京，首都医科大学宣武医院普通外科
  • 收稿日期:2017-05-02 出版日期:2017-08-30
  • 通信作者: 刘殿刚
  • 基金资助:
    北京市215高层次卫生技术人才学术骨干项目(008-0088)

The efficiency of obesity treated by sleeve gastrectomy or Roux-en-Y gastric bypass : a Meta Analysis

Ruoxi Zhang1, Diangang Liu1,†(), Chao Zhang1, Xiang Gao1, Fei Li1   

  1. 1. Department of General Surgery, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
  • Received:2017-05-02 Published:2017-08-30
  • Corresponding author: Diangang Liu
  • About author:
    Corresponding author: Liu Diangang, Email:
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引用本文：

张若蹊, 刘殿刚, 张超, 高翔, 李非. 袖状胃切除术和Roux-en-Y胃旁路术治疗肥胖症疗效的Meta分析[J]. 中华肥胖与代谢病电子杂志, 2017, 03(03): 143-149.

Ruoxi Zhang, Diangang Liu, Chao Zhang, Xiang Gao, Fei Li. The efficiency of obesity treated by sleeve gastrectomy or Roux-en-Y gastric bypass : a Meta Analysis[J]. Chinese Journal of Obesity and Metabolic Diseases(Electronic Edition), 2017, 03(03): 143-149.

目的

探讨袖状胃切除术（SG）与Roux-en-Y胃旁路术（RYGB）对肥胖症的疗效以及手术并发症发生率和围手术期死亡率。

方法

以"obesity surgery" "bariatric surgery" "sleeve gastrectomy" "Roux-en-Y gastric bypass" "obesity" "减重手术" "代谢手术" "Roux-en-Y胃旁路术" "袖状胃切除术" "肥胖"等为检索词分别检索Pubmed、EMBASE、Cochrane Library、CNKI、万方等中英文数据库。最终共纳入9篇病例对照研究进行Meta分析。

结果

共纳入病例539例，袖状胃切除术244例，Roux-en-Y胃旁路术295例，袖状胃切除术在体重变化方面差于Roux-en-Y胃旁路术，而在体质量指数、多余体重降低百分比、并发症发生率、糖化血红蛋白变化值、2型糖尿病缓解率方面两种手术术式效果相当，无围手术期死亡报道。

结论

袖状胃切除术与Roux-en-Y胃旁路术治疗肥胖症的效果相当、手术并发症及围手术期死亡率无明显差异，均可作为治疗肥胖症的优选术式。

关键词: 袖状胃切除术, 胃旁路术, 肥胖症, Meta分析
Objective

To analyze the effect, the complication rate and the preoperative mobility of sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) for the treatment of obesity.

Methods

Electronic literature search was performed on Pubmed, EMBASE, Cochrane Library, CNKI, Wangfang database using "obesity surgery" "bariatric surgery" "sleeve gastrectomy" "Roux-en-Y gastric bypass" for Chinese and English studies. Finally9 studies were included.

Results

Among the 9 studies, a total of 539 cases were reported, including 244 patients in the SG group, 295 patients in the RYGB group. Meta analysis showed RYGB had a significant advantage in the aspect of body weight. But no significant difference was found in the BMI, %EWL, HbA1c, the incidence of complications, the improvement of T2DM, and there is no mobility in perioperative time.

Conclusions

Sleeve gastrectomy and Roux-en-Y gastric bypass could be considered as great choices for treating obesity.

Key words: SG, RYGB, Obesity, Meta analysis
表1 纳入研究的基本特征
作者 出版时间 文章类别 国家 病例数（SG/RYGB） 性别(F/M) 年龄（SG/RYGB） 随访时间 JADAD评分
Paluszkiewicz 2012 RCT 波兰 36/36 49/23 44.9/43.9 1年 8
Yang 2015 RCT 中国 32/32 42/22 40.4/41.4 3年 11
Peterli 2012 RCT 瑞士 11/12 17/6 35.2/41.4 1年 10
Roslin 2012 RCT 美国 13/12 无 无 0.5年 14
Woelnerhanssen 2011 RCT 瑞士 11/12 无 35.2/41.4 1年 13
Kehagias 2011 RCT 希腊 30/30 44/16 33.7/36 3年 14
Benaiges 2011 RCT 西班牙 45/95 119/21 44.1/46.1 1年 11
Schauer 2012 RCT 美国 50/50 68/32 47.9/48.3 1年 14
Lee 2011 RCT 台湾 16/16 23/9 45.8/44.1 2年 13
图1 纳入研究的质量评价
图2 BMI指标的Meta分析结果
图3 BMI指标异质性分析Galbraith图
图4 %EWL指标的Meta分析结果
图5 并发症发生率的Meta分析结果
图6 T2DM术后缓解率的Meta分析结果
图7 HbA1c指标异质性分析Galbraith图
图8 HbA1c指标的Meta分析结果
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