St. Elizabeth Hospital, Gonzales, LA 70737, USA.
Obes Surg. 2011 Feb;21(2):146-50. doi: 10.1007/s11695-010-0320-y.
Laparoscopic sleeve gastrectomy (LSG) is gaining acceptance among bariatric surgeons as a viable option for treating morbidly obese patients. We describe results of a single surgeon's experience with LSG in a community practice revealing a low complication rate and describing the surgical technique.
LSG was performed in 529 consecutive patients from December 2006 to March 2010. A technique is described where all operations were performed with attention to avoiding strictures at the incisura angularis and stapling close to the esophagus at the angle of His. No operations performed used buttressing material or over-sewing of the staple line. A retrospective chart review and e-mail survey was conducted to determine the occurrence of complications and weight loss.
Follow-up data was collected on 490 of the 529 (92.6%) patients at 6 weeks. A total complication rate of 3.2% and a 1.7% 30-day readmission rate were observed. No leaks occurred in any of the 529 patients, and one death (0.19%) was observed. The most common complications were nausea and vomiting with dehydration and venous thrombosis. The percentages of excess weight loss were 42.36, 65.92, 66.11, and 64.42 with a follow-up of 71%, 68%, 63%, and 49% at 6 months, 1 year, 2, and 3 years, respectively.
The LSG can be performed in a community practice with a low complication rate. Surgeons performing LSG should strive to minimize the risk of creating strictures at the incisura angularis and stapling near the esophagus at the angle of His.
腹腔镜袖状胃切除术（LSG）作为治疗病态肥胖患者的可行选择，在减重外科医生中越来越受欢迎。我们描述了一位在社区实践中进行 LSG 的外科医生的经验结果，结果显示并发症发生率低，并描述了手术技术。
2006 年 12 月至 2010 年 3 月，我们对 529 例连续患者进行了 LSG。描述了一种技术，其中所有手术均注意避免在角切迹处形成狭窄，并在 His 角处靠近食管进行吻合。没有使用支撑材料或缝合钉线的手术。通过回顾性图表审查和电子邮件调查，确定并发症和体重减轻的发生情况。
对 529 例患者中的 490 例（92.6%）进行了 6 周的随访。观察到总并发症发生率为 3.2%，30 天再入院率为 1.7%。在 529 例患者中没有发生任何漏诊，仅观察到 1 例死亡（0.19%）。最常见的并发症是恶心、呕吐伴脱水和静脉血栓形成。6 个月、1 年、2 年和 3 年时的超额体重减轻百分比分别为 42.36%、65.92%、66.11%和 64.42%，随访率分别为 71%、68%、63%和 49%。
LSG 可以在社区实践中进行，并发症发生率低。进行 LSG 的外科医生应努力最大限度地降低在角切迹处形成狭窄和在 His 角处靠近食管吻合的风险。
