Department of Surgery, Michigan State University, East Lansing, MI, USA.
Obes Surg. 2012 Jan;22(1):4-7. doi: 10.1007/s11695-011-0529-4.
Complications after laparoscopic Roux-en-Y gastric bypass surgery may be related to the type of surgical technique employed. One technique, the placement of a Roux limb stabilization suture, presumably prevents kink at the gastrojejunal anastomosis. However, it can have an adverse effect and we studied a series of cases presenting with intestinal obstruction secondary to this stitch.
A retrospective review of a prospectively collected database of laparoscopic Roux-en-Y gastric bypass cases who had reoperations for Roux limb volvulus was performed at a single bariatric center by a single surgeon.
Out of 199 patients who underwent laparoscopic Roux en Y gastric bypass with placement of Roux limb stabilization suture, 4 patients (2.01%) presented with Roux limb volvulus postoperatively. BMI was 45.35 ± 2.95. The postoperative time to presentation was 11 ± 10.6 months. All four patients required surgical exploration to reduce the volvulus. In all cases, the Roux limb volvulus was directly attributable to the presence of the stabilization suture. In subsequent 250 cases where this suture was eliminated, there was no volvulus of Roux limb seen.
The use of a stabilization suture can result in volvulus of the Roux limb causing intestinal obstruction and this complication can be prevented by avoiding this suture.
腹腔镜 Roux-en-Y 胃旁路手术后的并发症可能与所采用的手术技术类型有关。一种技术，即 Roux 肢体稳定缝线的放置，据推测可以防止胃空肠吻合处的扭结。然而，它可能会产生不良影响，我们研究了一系列因这种缝线而导致肠梗阻的病例。
对一名外科医生在一家单一减重中心进行的前瞻性收集的腹腔镜 Roux-en-Y 胃旁路手术病例数据库中，因 Roux 肢体扭转而再次手术的病例进行了回顾性分析。
在接受腹腔镜 Roux en Y 胃旁路术和 Roux 肢体稳定缝线放置的 199 例患者中，有 4 例（2.01%）术后出现 Roux 肢体扭转。BMI 为 45.35±2.95。术后出现时间为 11±10.6 个月。所有 4 例患者均需手术探查以减轻扭转。在所有病例中，Roux 肢体扭转直接归因于稳定缝线的存在。在随后的 250 例未使用这种缝线的病例中，未出现 Roux 肢体扭转。
使用稳定缝线可导致 Roux 肢体扭转引起肠梗阻，通过避免使用这种缝线可以预防这种并发症。
