Mittermair Reinhard, Sucher Robert, Perathoner Alexander
Surg Today. 2014 Jul;44(7):1307-12. doi: 10.1007/s00595-013-0688-0.
Laparoscopic sleeve gastrectomy (SG) has gained popularity and acceptance among bariatric surgeons, mainly due its low morbidity and mortality. The purpose of the present study was to evaluate the efficacy of SG on weight loss, and to determine the postoperative course, clinical presentation and treatment of complications after SG.
Between January 2006 and October 2012, 153 consecutive patients underwent SG. All data were prospectively collected in a computerized database.
This series comprised 119 females and 34 males with a median age of 46 years and a median preoperative BMI of 42.3 kg/m2. The median EWL was 53.0 % after 18.4 months of follow-up. The median postoperative BMI was 33.3 kg/m2 (range 19.7–56.1 kg/m2). Eight patients (5.2 %) required re-laparoscopy to manage postoperative hemorrhage (3.3 %) and leakage (1.9 %). Neither abdominal drains nor postoperative contrast-swallow studies were successful in diagnosing hemorrhage or leaks in our patients.
SG is an effective procedure to achieve significant short-term weight loss. Clinical signs, such as tachycardia, pain, fever and hypotension, provide the best evidence of the presence of postoperative leakage or bleeding. An early diagnosis of these complications is the key to ensuring adequate treatment with immediate re-laparoscopy.
腹腔镜袖状胃切除术(SG)在减重外科医生中越来越受欢迎并得到认可,主要因其低发病率和死亡率。本研究的目的是评估SG在减重方面的疗效,并确定SG术后的病程、临床表现及并发症的治疗方法。
2006年1月至2012年10月期间,153例连续患者接受了SG手术。所有数据均前瞻性收集于计算机数据库中。
该系列包括119名女性和34名男性,中位年龄46岁,术前中位BMI为42.3kg/m²。随访18.4个月后,中位EWL为53.0%。术后中位BMI为33.3kg/m²(范围19.7 - 56.1kg/m²)。8例患者(5.2%)因术后出血(3.3%)和渗漏(1.9%)需要再次腹腔镜手术处理。在我们的患者中,腹部引流管和术后吞钡造影检查均未能成功诊断出血或渗漏。
SG是实现显著短期减重的有效手术。心动过速、疼痛、发热和低血压等临床体征是术后存在渗漏或出血的最佳证据。早期诊断这些并发症是确保立即进行再次腹腔镜手术以获得充分治疗的关键。