Table 1_Decision regret and long-term weight evolution following laparoscopic sleeve gastrectomy as bridge to kidney transplantation.docx

IntroductionLaparoscopic sleeve gastrectomy (LSG) is effective for rapid weight loss in kidney transplant (KT) candidates. This study aims to evaluate satisfaction or regret with the decision to undergo LSG in preparation for KT and the long-term durability of this approach to weight loss.
MethodsFrom 2012 to 2019, all patients who underwent LSG prior to waitlisting for KT were included. The Decision Regret Scale (DRS) was assessed regarding the decision to undergo LSG before KT. The long-term weight evolution was also collected.
FindingsForty-six subjects completed the DRS survey at a median follow-up of 8 years post-LSG: 67% reported absolutely no regret, 22% mild regret, and 11% moderate to strong regret. Successful surgical weight loss was achieved in 36 patients and was significantly associated with lower levels of regret (p = 0.005). Body mass index reductions after LSG were highly significant compared to baseline values at all time points over 10 years (p = 0.0001) and remained significantly lower for up to 7 years post-KT. Thirty-two patients received KT, yet this had no significant association with decision regret.
ConclusionLaparoscopic sleeve gastrectomy as a pre-transplantation weight loss strategy is associated with very low levels of regret, regardless of the KT status. LSG has demonstrated long-term, durable weight loss.

引言
腹腔镜袖状胃切除术（Laparoscopic Sleeve Gastrectomy, LSG）可有效帮助肾移植（Kidney Transplant, KT）候选者实现快速减重。本研究旨在评估这类受者为准备肾移植而接受LSG的决策满意度与决策后悔程度，同时考察该减重方案的长期减重持久性。

方法
2012年至2019年间，本研究纳入所有在进入肾移植等待名单前接受LSG的患者。研究采用决策后悔量表（Decision Regret Scale, DRS）对患者为肾移植准备而接受LSG的决策进行后悔程度评估，并收集患者的长期体重变化数据。

结果
46名受试者在LSG术后中位随访8年时完成了DRS问卷：其中67%表示完全无后悔，22%存在轻度后悔，11%存在中度至重度后悔。36例患者实现了手术成功减重，该结果与更低的后悔程度显著相关（p=0.005）。与基线值相比，LSG术后10年内各时间点的体质量指数降幅均具有极显著统计学意义（p=0.0001），且在肾移植术后长达7年的时间里仍维持在较低水平。共有32例患者接受了肾移植，但该情况与决策后悔程度无显著相关性。

结论
作为移植前减重方案的腹腔镜袖状胃切除术，无论受者是否完成肾移植，其相关决策的后悔程度均处于极低水平。LSG已被证实可实现长期且持久的减重效果。