Comparative Study On Curative Effect Of Different Bariatric Surgery In The Treatment Of Metabolic Syndrome

Objective:To compare the efficacy of laparoscopic sleeve gastrectomy on and laparoscopic fundoplication with sleeve gastrectomy in the treatment of metabolic syndrome.Methods:The clinical data of 73 patients with metabolic syndrome who were underwent bariatric surgery in the People’s Hospital of Xinjiang Uygur Autonomous Region from January 2018 to June 2019 were retrospectively analyzed.They were devided into LSG group and LFDSG group according to the different surgical methods.Among the 38 cases of LSG group,23 cases were male and 15 cases were female with the average age of（37.2+11.7）years old.Among the 35 cases of LFDSG group,19 cases were male and 16 cases were female with the average age of（37.9+11.1）years old.Body weight,body composition,blood glucose and lipids metabolism,blood pressure,obstrcutive sleep apnea parameters and biochemical indexes were compared between two groups.Results:All patients were treated successfully by bariatric surgery and followed up 6 months after operation,there were no serious complications during this time.In the LFDSG group blood loss,operation time is longer than LSG group,there were significant differences（P<0.05）;At postoperative 6 months,both LSG group and LFDSG group,their body weight,body mass index,waist、hip、neck circumference,excessive weight lost,glycosylated hemoglobinA1c,fasting blood glucose,fasting blood insulin,homeostasis model assessment of insulin resistance index（HOMA-IR）,uric acid,triglyceride,total cholesterol,low density lipoprotein（LDL）,visceral fat area（VFA）,body fat（BF）,body fat percentage（PBF）,blood pressure,apnea hypopnea index（AHI）were significantly decreased than preoperative,the difference was statistically significant（P<0.05）.Average oxygen saturation（ASaO₂）,lowest oxygen saturation（LSaO₂）,high density lipoprotein（HDL）,insulin sensitivity index（ISI）were significantly decreased than preoperative,the difference was statistically significant（P<0.05）.there is no significant differences between two groups（P>0.05）.Conclusions:（1）LSG and LFDSG can both significantly cure and（or）improve metabolic syndrome in a short time,there is no significant different between the two groups;（2）compared with LSG surgery,LFDSG surgery has the advantages of preventing the disappearance of the His angle,damage to the cardia muscle fibers,and rupture of the esophageal ligament,thereby retaining a certain anti-reflux barrier.However,the operation time is long and the flexibility of the operation is difficult.