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袖状胃切除术作为病态肥胖患者减重主要手术方式的适应证。

Indications for sleeve gastrectomy as a primary procedure for weight loss in the morbidly obese.

作者信息

Tucker O N, Szomstein S, Rosenthal R J

机构信息

The Bariatric Institute, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd, Weston, FL 33331, USA.

出版信息

J Gastrointest Surg. 2008 Apr;12(4):662-7. doi: 10.1007/s11605-008-0480-4. Epub 2008 Feb 9.

Abstract

BACKGROUND

Single-stage laparoscopic sleeve gastrectomy (LSG) may represent an additional surgical option for morbid obesity.

METHODS

We performed a retrospective review of a prospectively maintained database of LSG performed from November 2004 to April 2007 as a one-stage primary restrictive procedure.

RESULTS

One hundred forty-eight LSGs were performed as primary procedures for weight loss. The mean patient age was 42 years (range, 13-79), mean body mass index of 43.4 kg/m(2) (range, 35-75), mean operative time of 60 min (range, 58-190), and mean blood loss of 60 ml (range, 0-300). One hundred forty-seven procedures (99.3%) were completed laparoscopically, with a mean hospital stay of 2.7 days (range, 2-25). A 2.7% major complication rate was observed with four events in three patients and no deaths. Four patients required readmission; mild dehydration in two, choledocholithiasis in one, and a gastric sleeve stricture in one.

CONCLUSION

Laparoscopic SG is a safe one-stage restrictive technique as a primary procedure for weight loss in the morbidly obese with an acceptable operative time, intraoperative blood loss, and perioperative complication rate.

摘要

背景

单阶段腹腔镜袖状胃切除术(LSG)可能是治疗病态肥胖的另一种手术选择。

方法

我们对2004年11月至2007年4月期间作为单阶段主要限制性手术进行的LSG前瞻性维护数据库进行了回顾性分析。

结果

148例LSG作为减肥的主要手术进行。患者平均年龄42岁(范围13 - 79岁),平均体重指数43.4 kg/m²(范围35 - 75),平均手术时间60分钟(范围58 - 190分钟),平均失血量60毫升(范围0 - 300毫升)。147例手术(99.3%)通过腹腔镜完成,平均住院时间2.7天(范围2 - 25天)。观察到主要并发症发生率为2.7%,3例患者发生4起事件,无死亡病例。4例患者需要再次入院;2例为轻度脱水,1例为胆总管结石,1例为胃袖状狭窄。

结论

腹腔镜袖状胃切除术是一种安全的单阶段限制性技术,作为病态肥胖患者减肥的主要手术,其手术时间、术中失血量和围手术期并发症发生率均可接受。

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