Prader-Willi syndrome Kcal 図 2: ポート位置 Ⅲ 方法 cm Fr cm mm ICU percent of excess weight loss %EWL BMI EWL 図 3: ステイプラーで胃を切離図 4: 漿膜筋層の手縫い縫合図 5: 右側ポート (15m

Size: px

Start display at page:

Download "Prader-Willi syndrome Kcal 図 2: ポート位置 Ⅲ 方法 cm Fr cm mm ICU percent of excess weight loss %EWL BMI EWL 図 3: ステイプラーで胃を切離図 4: 漿膜筋層の手縫い縫合図 5: 右側ポート (15m"

いちえいまつかた
5 years ago
Views:

1 - 報告細谷好則 1, 春田英律 1, 石橋俊 2, 倉科憲太郎 1, 瑞木亨 1,Alan Lefor 1, 佐田尚宏 1, 永島秀一 2, 大須賀淳一 2, 安藤康宏 3, 江口和男 4, 岡島美朗 5, 布宮伸 6, 竹内護 7, 佐藤敏子 8, 矢田俊彦 9, 多賀谷信美 10, 川村功 11 1, 安田是和 - - 要約 Sleeve BMI kg/ BMI kg/ - - -Kg BMI - cc Billiopancreatic diversion BMI Ⅰ 緒言 Restrictive Restrictive + malabsoptive Bariatric Surgery Metabolic Surgery Ⅱ 対象 jsto/gakujyutsu/index.html Body mass index BMIkg/ BMI kg/ hosoyo@jichi.ac.jp

2 Prader-Willi syndrome Kcal 図 2: ポート位置 Ⅲ 方法 cm Fr cm mm ICU percent of excess weight loss %EWL BMI EWL 図 3: ステイプラーで胃を切離図 4: 漿膜筋層の手縫い縫合図 5: 右側ポート (15mm) から大弯側胃の摘出図 1: スリーブ状胃切除のシェーマ

3 - Ⅳ 結果 - -Kg BMI - cc- Sleeve Sleeve Billiopancreatic diversion Roux-en-Y common channel BMI EWL,,,,, Ⅴ 考察 BMI kg/ BMI kg/ National Institutes of Health NIH NIH BMI BMI Consensus Meeting BMI kg/bmi kg/ BMI kg/bmi kg/.... 表 1 DM kg BMI kg/m kg BMI kg/m kg BMI kg/m EWL F HT DM HL.. HL HT F OA HL FL.. OA F OA HT DM FL.. DM HT F HT HL FL MI.. HT HL MI M OA OSAS HL FL DM.. CPAP DM HL M OA OSAS HT FL UP.. CPAP F OA OSAS HT FL HU HT HU M OA OSAS DM HU DM HU HT DM HL HU FL UP OAOSAS MI

4 図 6: 世界の肥満外科手術の適応 NIH National Institutes of Health, ASMBS American Society for Metabolic and Bariatric Surgery org/, APBSS Asia Pacific Bariatric Surgery Society,, SAGES Society of American Gastrointestinal and Endoscopic Surgeons ADA American Diabetes Association, IFSO International Federation of Surgery for Obesity and metabolic disorders, EC European chapter, ASMBS North American Chapter, APC Asian Pacific Chapter. / / / - EWL % n= % n= n=. % BMI BMI> R-Y Sleeve R-Y Lee WJ R-Y Ⅵ 謝辞 Ⅶ 文献 Buchwald H, Avidor Y, Braunwald E et al Bariatric surgery a systematic review and meta-analysis. JAMA -. Sjostrom L, Narbro K, Sjostrom CD et al Swedish Obese Subjects Study. Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med

5 - -. Adams TD, Gress RE, Smith SC et al Long-term mortality after gastric bypass surgery. N Engl J Med -. Buchwald H, Oien DM Metabolic/bariatric surgery Worldwide. Obes Surg -. Farrell TM, Haggerty SP, Overby DW, et al. Clinical application of laparoscopic bariatric surgery an evidence-based review. Surg Endosc -. Tokunaga K, Matsuzawa Y, Kotani K et al Ideal body weight estimated from the body mass index with the lowest morbidity. Int J Obes -. Deitel M, Gawdat K, Melissas J. Reporting weight loss. Obes Surg -. National Institutes of Health. The Practical Guide Identification, Evaluation, and Treatment of Overweight and Obesity in Adults. Bethesda, MD National Institutes of Health, National Heart, Lung, Blood Institutes, and North American Association for the Study of Obesity. NIH Publication Number -,. Kanazawa M, Yoshiike N, Osaka T et al Criteria and classification of obesity in Japan and Asia-Oceania. Asia Pac J Clin Nutr S -S,. Lee WJ, Wang W Bariatric surgery Asia-Pacific perspective. Obes Surg -. Christou NV, Sampalis JS, Liberman M et al Surgery decreases long-term mortality, morbidity, and health care use in morbidly obese patients. Ann Surg -. Ohta M, Kitano S, Kasama K et al Results of a national survey on laparoscopic bariatric surgery in Japan, -. Asian J Endosc Surg ISSN -. Kasama K, Tagaya N, Kanahira E et al Has laparoscopic bariatric surgery been accepted in Japan? The experience of a single surgeon. Obes Surg -. Fuks D, Verhaeghe P, Brehant O et al Results of laparoscopic sleeve gastrectomy a prospective study in patients with morbid obesity. Surgery -. Gagner M, Deitel M, Kalberer TL et al The Second International Consensus Summit for Sleeve Gastrectomy, March -,. Surg Obes Relat Dis -. Ferrer-Marquez M, Belda-Lozano R, Ferrer-Ayza M Technical Controversies in Laparoscopic Sleeve Gastrectomy. Obes Surg -. Himpens J, Dobbeleir J, Peeters G Long-term results of laparoscopic sleeve gastrectomy for obesity. Ann Surg - Braghetto I, Korn O, Valladares H et al Laparoscopic sleeve gastrectomy surgical technique, indications and clinical results. Obes Surg -. Baltasar A, Serra C, Perez N et al Re-sleeve gastrectomy. Obes Surg -. Langer FB, Bohdjalian A, Shakeri-Leidenmuhler S et al Conversion from sleeve gastrectomy to Roux-en-Y gastric bypass--indications and outcome.obes Surg -. de Gordejuela AG, Pujol Gebelli J, Garcia NV, et al. Is sleeve gastrectomy as effective as gastric bypass for remission of type diabetes in morbidly obese patients? Surg Obes Relat Dis -. Vidal J, Ibarzabal A, Romero F, et al. Type diabetes mellitus and the metabolic syndrome following sleeve gastrectomy in severely obese subjects.obes Surg -. Rao RS, Kini S. Diabetic and bariatric surgery a review of the recent trends. Surg Endosc -. Lee WJ, Chong K, Ser KH et al Gastric bypass vs sleeve gastrectomy for type diabetes mellitus a randomized controlled trial. Arch Surg -.

6 Jichi Medical University Journal - Short-term follow-up results of laparoscopic sleeve gastrectomy for morbid obesity at Jichi Medical University Hospital Yoshinori Hosoya, Hidenori Haruta, Shun Ishibashi, Kentaro Kurashina, Toru Zuiki, Alan Lefor, Naohiro Sata, Shuichi Nagashima, Junichi Osuga, Yasuhiro Ando, Kazuo Eguchi, Yoshiaki Okajima, Shin Nunomiya, Mamoru Takeuchi, Toshiko Sato, Toshihiko Yada, Nobumi Takaya, Isao Kawamura, Yoshikazu Yasuda Departments of Surgery, Endocrinology, Nephrology, Cardiology, Psychology, Intensive Care Unit, Anesthesiology, Nutrition Unit, Physiology, Jichi Medical University, Dokkyo University Koshigaya Hospital, Toho University Sakura Hospital Abstract In July, laparoscopic sleeve gastrectomy for treatment of patients with morbid obesity was introduced at Jichi Medical University Hospital. Decisions to treat surgically are made according to criteria of the Japan Society for the Treatment of Obesity indications include the following BMI kg/m or BMI kg/m with co-morbidities age - and primary obesity. After consultation with the Departments of Internal Medicine, Surgery, and Psychology, approval of the Ethics committee is obtained. Eight patients male, female have been treated. Preoperative median range values for this group included the following age - years, body weight -kg, and BMI -. The median operating time was minutes with a mean estimated blood loss of ml. There were no severe adverse events such as leakages or bleeding. Stasis due to twisting of the remnant stomach occurred in patient, who underwent uneventful revision by laparoscopic biliarypancreatic diversion. The median follow-up period was days, and the median BMI year postoperatively for patients was, for an excess weight loss of %. The other patients have experienced rapid weight loss. All preexisting co-morbidities, including diabetes, hyperlipidemia, and amenorrhea, have resolved. This hospital has received advanced medical technology from the Ministry of Health, Japan. In summary the outcomes for a series of laparoscopic sleeve gastrectomy procedures in this hospital, and a review of the literature, are presented. Key words bariatric surgery, laparoscopic sleeve gastrectomy, metabolic surgery Correspondence to Yoshinori Hosoya, Departments of Surgery, Jichi Medical University, Tochigi,Japan -, hosoyo@jichi.ac.jp Received April Accepted November

268 LSG 図 Lee ABCD 表 1 4 Age BMI C Duration Still DiaRem 表 1 4 HbA1c Ⅱ 対象と方法 1 17 LSG 6 3 Excess Weight Loss EWL BMI 25 kg/m 2 Hb

268 LSG 図 Lee ABCD 表 1 4 Age BMI C Duration Still DiaRem 表 1 4 HbA1c Ⅱ 対象と方法 1 17 LSG 6 3 Excess Weight Loss EWL BMI 25 kg/m 2 Hb 52 5 18 1 267 原著 ( 臨床研究 ) LSG ABCD DiaRem LSG 3 93.1 1 7.8 CR37.5 PR33.3 1 ABCD 5 DiaRem 12 LSG ABCD DiaRem LSG 腹腔鏡下スリーブ状胃切除術,ABCD スコア,DiaRem スコア Ⅰ はじめに Bariatric Surgery 2 1 metabolic surgery 2 ABCD 2

Prader-Willi syndrome Kcal 図 2: ポート位置 Ⅲ 方法 cm Fr cm mm ICU percent of excess weight loss %EWL BMI EWL 図 3: ステイプラーで胃を切離 図 4: 漿膜筋層の手縫い縫合 図 5: 右側ポート (15m

Prader-Willi syndrome Kcal 図 2: ポート位置 Ⅲ 方法 cm Fr cm mm ICU percent of excess weight loss %EWL BMI EWL 図 3: ステイプラーで胃を切離図 4: 漿膜筋層の手縫い縫合図 5: 右側ポート (15m