Early Clinical Treatment Analysis Of Laparoscopic Sleeve Gastrectomy For Obesity

Objective: To evaluate the clinical treatment and surgical safety of laparoscopic sleeve gastrectomy(LSG),our study collects some parameters of the patients with obesity after LSG,the parameters including the variation of weight,incidence of complications,changes in blood lipid level and changes in blood glucose related indicators of patients combined with diabetes.Method: Collect the clinical data of obesity patients who were done the LSG in Tianjin Medical University General Hospital at December,2014 ~ August,2017.22 cases in total,and follow-up times is 6 months.Record their weight,body mass index(BMI),triglyceride(TG),blood glucose related parameters of patients with diabetes and total cholesterol(TC)at the exact time including preoperative and 1 month,3 months,6 months after operation,calculate the percentage of excess weight loss(EWL %)as well.Then compare the preoperative and postoperative parameters.All the data were presented in Mean ± Standard Deviation and p values less than 0.05 was considered to be statistically significant in SPSS 17.0.Result: All surgeries of 22 cases were completed successfully by the laparoscopic,without transfer laparotomy and intraoperative serious complications.There were venous thrombosis between lower limb muscle in 1 case,nausea and vomiting in 2 cases,pulmonary infection in 1 case after operation,no severe complications such as digestive tract fistula and postoperative bleeding.All cases were followed-up completedly at least 6 months after operation.The average duration of operation was(212.7±73.9)min,the average intraoperative blood loss quantity was(57.3±80.1)ml,the average postoperative exhaust time was(1.6±0.6)d,the average postoperative eating liquid time was(2.9±0.6)d,the average postoperative hospital stay time was(7.1±3.5)d,the average total hospitalization time was(9.6±4.3)d.The weight and BMI of 1 month,3 months,6 months after operation were significantly lower than the preoperative level,the difference of weight was statistically significant between 3 months after surgery and preoperative,6 months after surgery and preoperative,6 months after surgery and 1months after surgery,as the BMI,the difference statistically significant group adds 6 months after surgery and 3 months after surgery(P<0.05).The difference was statistically significant the EWL % increased significantly(P<0.05).By the end of 6 months after operation,9 cases had excellent weight loss and 13 cases had good weight loss.Compare with preoperative level,TG and TC showed a downward trend at 1,3,and 6 months after surgery.The difference of TC was statistically significant at 6 months after operation compared with preoperative(P<0.05).There was no significant difference in TG between the time points(P>0.05).FBG,2hPBG and HbAlc all decreased progressively by the time in 10 cases combined with diabetes,The difference was statistically significant at 6 months after surgery compared with preoperative of FBG,2hPBG and HbAlc(P<0.05).By the end of 6 months after operation,some diabetes patients had reduced dosage of antidiabetic drugs.Conclusion: LSG is a reliable operation method to treat obesity,with a good effecton losing weight,and can decrease the blood glucose,blood fat obviously.However,the cases in this study are insufficient,and the follow-up period is short,the long-term effect of LSG needs a further study.