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硅胶环 Roux-en-Y 胃旁路术治疗肥胖症:腹腔镜与剖腹手术对呼吸的影响。

Silicone-ring Roux-en-Y gastric bypass in the treatment of obesity: effects of laparoscopic versus laparotomic surgery on respiration.

机构信息

Methodist University of Piracicaba (UNIMEP), Piracicaba, São Paulo, Brazil.

出版信息

Obes Surg. 2011 Feb;21(2):194-9. doi: 10.1007/s11695-009-9823-9. Epub 2009 Mar 21.

Abstract

BACKGROUND

The objective of this study was to compare the effects of silicone-ring Roux-en-Y gastric bypass carried out by laparoscopy versus that accomplished by laparotomy on pulmonary function.

METHODS

A total of 26 women (body mass index (BMI) 35-49 kg/m(2)) were studied candidates for silicone-ring Roux-en-Y gastric bypass carried out by laparoscopy (LG; n = 13) and laparotomy (or open surgery (OG); n = 13). Smokers, patients having lung disease, and those unable to carry out the tests properly were excluded. The physical therapy was standardized for both the groups. Respiratory evaluation was carried out during the preoperative period and on the second postoperative day by using spirometry and other tests that evaluated respiratory muscle strength and diaphragmatic mobility. Pain was evaluated by the visual analog scale on the second postoperative day. The statistical analysis was carried out with parametric or nonparametric tests, depending on the distribution of variables, considering p < 0.05 as statistically significant.

RESULTS

Patients were similar with respect to age, BMI, and waist-to-hip ratio. A decrease in all variables was observed for both the groups in the postoperative period, although this decrease was less pronounced in the LG group. Pain intensity was also lower in the LG group. The length of hospital stay was 2 days, and there were no pulmonary complications.

CONCLUSION

As there were no differences in the incidence of pulmonary complications and the length of hospital stay between the groups, the results showed that silicone-ring Roux-en-Y gastric bypass carried out by laparoscopy caused less pain and impairment of pulmonary function in the postoperative period.

摘要

背景

本研究旨在比较腹腔镜下硅胶环 Roux-en-Y 胃旁路术与剖腹手术对肺功能的影响。

方法

共有 26 名女性(体重指数(BMI)35-49 kg/m²)被选为硅胶环 Roux-en-Y 胃旁路术的候选者,其中 13 名接受腹腔镜手术(LG),13 名接受剖腹手术(OG)。排除吸烟者、患有肺部疾病者和无法正确进行测试者。两组均进行标准化物理治疗。在术前和术后第二天,通过肺量测定和评估呼吸肌力量和横膈膜移动性的其他测试来进行呼吸评估。术后第二天通过视觉模拟评分评估疼痛。根据变量的分布,使用参数或非参数检验进行统计分析,认为 p<0.05 为统计学显著。

结果

两组患者在年龄、BMI 和腰臀比方面相似。两组术后所有变量均下降,但 LG 组下降幅度较小。LG 组疼痛强度也较低。住院时间为 2 天,无肺部并发症。

结论

由于两组之间的肺部并发症发生率和住院时间无差异,结果表明腹腔镜下硅胶环 Roux-en-Y 胃旁路术在术后引起的疼痛和肺功能损害较小。

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