FULL-THICKNESS ENDOSCOPIC GASTRIC RESECTION USING A STAPLER AND GASTROSTOMY: A FEASIBILITY STUDY

ABSTRACT Background: Laparoscopic sleeve gastrectomy (LSG) is currently the most frequently performed bariatric procedure in Turkey. The goal of weight reduction surgery is not only to decrease excess weight, but also to improve obesity related comorbidities and quality of life (QoL). Aim: To evaluate the impact of LSG on patient quality of life, weight loss, and comorbidities associated with morbid obesity according to the updated BAROS criteria. Methods: Eleven hundred thirty-eight adult patients were undergone to LSG by our bariatric surgery team between January 2013 and January 2016. A questionnaire (The Bariatric Analysis and Reporting Outcome System - BAROS) was published on social media. The data on postoperative complications were collected from hospital database. Results: Number of respondants was 562 (49.4%). Six of 1138 patients(0.5%) had leakage. All patients who had leakage were respondants. The overall complication rate was 7.7%. After a mean period of 7.4±5.3 months(1-30), mean excess weight loss was 71.3±27.1% (10.2-155.4). The respondants reported 772 comorbidities. Of these, 162 (30%) were improved, and 420 (54.4%) were resolved. The mean scores for QoL were significantly increased after LSG (range, p<0.05 to <0.001). Of the 562 patients, 26 (4.6%) were classified as failures; 86 (15.3%) fair; 196 (34.9%) good; 144 (25.6%) very good, and 110 (19.6%) excellent results according to the updated BAROS scoring system. Conclusion: LSG is a highly effective bariatric procedure in the manner of weight control, improvement in comorbidities and increasing of QoL in short- and mid-term.

摘要 背景：腹腔镜袖状胃切除术（Laparoscopic Sleeve Gastrectomy, LSG）是目前土耳其开展最为频繁的减重手术。减重手术的核心目标不仅在于降低患者多余体重，更旨在改善肥胖相关并发症并提升其生活质量（Quality of Life, QoL）。研究目的：依据更新版巴里亚特里奇分析与报告结局系统（Bariatric Analysis and Reporting Outcome System, BAROS）标准，评估LSG对患者生活质量、减重效果及病态肥胖相关并发症的影响。方法：2013年1月至2016年1月期间，本中心减重外科团队为1138例成年患者实施了LSG。研究通过社交媒体发布减重分析与报告结局系统（BAROS）调查问卷，术后并发症数据则从医院数据库中调取收集。结果：本次研究共回收有效问卷562份，回收率为49.4%。1138例患者中共有6例（0.5%）发生术后漏，且所有出现术后漏的患者均为有效受访者。总体并发症发生率为7.7%。术后平均随访时长为7.4±5.3个月（范围1~30个月），患者平均多余体重下降率为71.3±27.1%（范围10.2%~155.4%）。受访者共报告772项肥胖相关并发症，其中162项（30%）得到改善，420项（54.4%）完全缓解。术后患者的生活质量平均评分较术前显著提升（p值范围：<0.05至<0.001）。依据更新版BAROS评分系统，562例受访者中，26例（4.6%）被归类为失败组，86例（15.3%）为一般组，196例（34.9%）为良好组，144例（25.6%）为优秀组，110例（19.6%）为极佳组。结论：在短期与中期随访中，LSG在体重控制、并发症改善及生活质量提升方面均展现出优异的临床效果。