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Evidence-based medicine: open and laparoscopic bariatric surgery.

机译：循证医学：开放式和腹腔镜减肥术。

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BACKGROUND: The aim of this study was to perform an evidence-based analysis of the literature on open and laparoscopic surgery for morbid obesity. METHODS: Human studies on surgery for morbid obesity were conducted. Multiple publications of the same studies, abstracts, and case reports were reviewed. Current Contents, MEDLINE, EMBASE, and Cochrane Library databases were investigated. RESULTS: Open Roux-en-Y gastric by pass (RYGB) for morbidly obese patients and long-limb RYGB for superobese patients are highly effective procedures. Randomized controlled trials comparing malabsorptive procedures with other bariatric operations are needed. The long-term efficacy of adjustable silicone gastric banding (ASGB) still is undetermined because of poor evidence. Laparoscopic RYGB is as safe as its open counterpart, although its long-term results are lacking. Laparoscopic ASGB is less invasive than open ASGB, although its efficacy cannot be determined because of poor evidence. Laparoscopic vertical banded gastroplasty (VBG) is becoming unpopular since the decreasing trend of open VBG. Laparoscopic biliopancreatic diversion with duodenal switch is feasible, but needs further studies. CONCLUSIONS: Randomized controlled trials comparing the various laparoscopic operations are strongly needed.
机译：背景：本研究的目的是对病态肥胖的开放式和腹腔镜手术文献进行循证分析。方法：进行了人类对病态肥胖手术的研究。审查了相同研究，摘要和病例报告的多个出版物。研究了当前目录，MEDLINE，EMBASE和Cochrane库数据库。结果：对于病态肥胖的患者，开放式Roux-en-Y胃旁通气（RYGB）和对于超肥胖的患者，采用长肢RYGB是非常有效的方法。需要将吸收不良的手术与其他减肥手术进行比较的随机对照试验。由于证据不足，可调节的硅胶胃束带（ASGB）的长期疗效仍未确定。腹腔镜RYGB与开放式RYGB一样安全，尽管缺乏长期效果。腹腔镜ASG​​B的侵入性比开放式ASGB小，尽管由于证据不足而无法确定其疗效。由于开放性VBG的下降趋势，腹腔镜垂直带状胃成形术（VBG）变得不受欢迎。十二指肠开关的腹腔镜胆胰转移术是可行的，但需要进一步研究。结论：强烈需要比较各种腹腔镜手术的随机对照试验。

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