Clinical study of laparoscopic fundus folding combined with sleeve gastrectomy in the treatment of non-diabetic obesity

doi:10.3877/cma.j.issn.1674-3946.2022.04.012

Abstract

Abstract:

Objective

To compare the clinical effect of laparoscopic fundus folding combined with sleeve gastrectomy（LFDSG）and laparoscopic sleeve gastrectomy（LSG）in the treatment of non-diabetic obesity.

Methods

75 patients without diabetes who underwent weight loss surgery from January 2018 to June 2020 were prospectively selected and divided into LSG group（n=37 cases）and LFDSG group（n=38 cases）by random number method. SPSS 24.0 was used. Perioperative related indicators，esophageal acid reflux and esophageal manometry analysis，weight loss effect，changes in blood lipid and uric acid levels and other were represented by（

x ˉ

±s）and independent sample t test was performed. The incidence of postoperative complications and other statistical data were determined by χ² test or Fisher’s accurate test. P<0.05 was considered statistically significant.

Results

The operation time of LFDSG group was significantly longer than that of LSG group（P<0.05）；The incidence of total postoperative complications in LFDSG group was significantly lower than that in LSG group（2.6% vs. 21.6%，P<0.05）；The number of acid reflux（pH≤4），proximal esophageal acid reflux（%），DeMeester score，lower esophageal sphincter residual pressure reduction，distal esophageal contraction score of LFDSG group was significantly better than LSG group（P<0.05）；6 months after surgery，body weight，BMI，hip circumference，waist circumference and neck circumference of 2 groups were significantly improved compared with those before surgery（P<0.05），but there was no statistical significance between groups（P>0.05）. Compared with before surgery，triglyceride（TG），total cholesterol（TC），low density lipoprotein cholesterol（LDL-C）and uric acid（UA）in both groups were significantly decreased 6 months after surgery，while HDL-C level was significantly increased（P<0.05），but there was no statistical significance between groups（P>0.05）.

Conclusion

Compared with LSG surgery，LFDSG surgery has obvious weight loss effect in the treatment of non-diabetic obesity. It has fewer postoperative complications，can play an anti-reflux effect and improve the level of postoperative blood lipid and uric acid.

Key words: Laparoscopic fundus folding, Sleeve gastrectomy, Weight loss effect, Gastroesophageal reflux

Hongzhen Zhang, Jun Yu, Zuowen Yin, Shaowei Xiong, Peng Zhang. Clinical study of laparoscopic fundus folding combined with sleeve gastrectomy in the treatment of non-diabetic obesity[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2022, 16(04): 390-394.

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Figures/Tables 6

References 16

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组别	例	年龄(岁)	性别			BMI(kg/m²)
组别	例	年龄(岁)	男/女			BMI(kg/m²)
LSG组	37	46.9±7.6	20/17			42.9±2.5
LFDSG组	38	45.8±7.5	19/19			42.5±2.4
χ²/t		0.614	0.123			0.727
P		0.541	0.725			0.470
组别	例	病程(年)		术前合并症
组别	例	病程(年)		a	b		c	d
LSG组	37	2.0±0.4		32	30		11	8
LFDSG组	38	2.1±0.4		31	29		12	9
χ²/t		0.486		0.336	0.254		0.030	0.045
P		0.628		0.562	0.615		0.862	0.831

组别	例	年龄(岁)	性别			BMI(kg/m²)
组别	例	年龄(岁)	男/女			BMI(kg/m²)
LSG组	37	46.9±7.6	20/17			42.9±2.5
LFDSG组	38	45.8±7.5	19/19			42.5±2.4
χ²/t		0.614	0.123			0.727
P		0.541	0.725			0.470
组别	例	病程(年)		术前合并症
组别	例	病程(年)		a	b		c	d
LSG组	37	2.0±0.4		32	30		11	8
LFDSG组	38	2.1±0.4		31	29		12	9
χ²/t		0.486		0.336	0.254		0.030	0.045
P		0.628		0.562	0.615		0.862	0.831

组别	例	手术时间 (min)	术中出血量 (ml)	通气时间 (d）	住院时间 (d）
LSG组	37	86.2±11.9	50.2±8.5	2.3±0.6	5.9±1.6
LFDSG组	38	97.6±13.7	49.8±7.9	2.5±0.8	5.8±1.9
t		3.825	0.189	1.064	0.121
P		<0.001	0.851	0.291	0.904

组别	例	手术时间 (min)	术中出血量 (ml)	通气时间 (d）	住院时间 (d）
LSG组	37	86.2±11.9	50.2±8.5	2.3±0.6	5.9±1.6
LFDSG组	38	97.6±13.7	49.8±7.9	2.5±0.8	5.8±1.9
t		3.825	0.189	1.064	0.121
P		<0.001	0.851	0.291	0.904

组别	例	术后并发症			总并发症
组别	例	食管反流	胃漏	深静脉血栓	总并发症
LSG组	37	4(10.8)	3(8.1)	1(2.7)	8(21.6)
LFDSG组	38	0(0.0)	1(2.6)	0(0.0)	1(2.6)
χ²		-	-	-	4.789
P		-	-	-	0.029

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