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采用机械圆形胃肠吻合术的纯经脐单孔腹腔镜胃旁路手术的可行性

Pure transumbilical SILS gastric bypass with mechanical circular gastrojejunal anastomosis feasibility.

作者信息

Pitot Denis, Takieddine Mazen, Abbassi Ziad, Agrafiotis Apostolos, Bruyns Laurence, Ceuterick Michel, Daoudi Nabil, Dolimont Amaury, Soulimani Abdelak, Vaneukem Pol

机构信息

Service de Chirurgie Digestive, CHU Charleroi, 92, boulevard P. Janson, 6000, Charleroi, Belgium,

出版信息

Surg Endosc. 2014 Oct;28(10):3007-11. doi: 10.1007/s00464-014-3562-2. Epub 2014 May 23.

Abstract

BACKGROUND

Since Wittgrove introduced the laparoscopic version of the gastric bypass in 1994, the interest still remains in the decrease of the abdominal wall trauma in order to optimize the benefits of laparoscopy on postoperative pain, cosmesis, hospital stay, and convalescence in bariatric patients. This work is to report the feasibility of gastric bypass surgery by a pure transumbilical single-incision laparoscopic surgery (SILS) with a mechanical circular gastrojejunal anastomosis.

METHODS

Thirty-four patients (10 males and 24 females) were offered to receive gastric bypass with circular mechanical gastrojejunal anastomosis by Single Incision Laparoscopic Surgery (SILS) using pure transumbilical access. Anastomotic leak occurrence was the primary end-point. Patients demographics, operative time, additional trocarts, hemorrhage, intra abdominal abscess, length of post-operative stay, readmission, 30 days death, gastrojejunal anastomosis stricture, marginal ulcers, reflux complains, seromas, incisional hernias, and % excess BMI loss were also recorded in a prospective database.

RESULTS

Primary end-point showed no anastomotic leak occurrence during the hospital stay or during the first 30 post-operative days. SILS gastric bypass with a circular mechanical gastrojejunal anastomosis is feasible and seems to be safe.

摘要

背景

自1994年维特格罗夫引入腹腔镜胃旁路手术以来,人们仍对减少腹壁创伤感兴趣,以便优化腹腔镜手术在肥胖症患者术后疼痛、美容效果、住院时间和康复方面的益处。本研究旨在报告采用机械圆形胃空肠吻合术的纯经脐单切口腹腔镜手术(SILS)进行胃旁路手术的可行性。

方法

34例患者(10例男性,24例女性)接受了经纯经脐入路的单切口腹腔镜手术(SILS),采用圆形机械胃空肠吻合术进行胃旁路手术。吻合口漏的发生是主要终点。患者的人口统计学资料、手术时间、额外的套管针、出血、腹腔内脓肿、术后住院时间、再次入院、30天死亡率、胃空肠吻合口狭窄、边缘性溃疡、反流症状、血清肿、切口疝以及体重指数(BMI)超标减少百分比等数据也记录在前瞻性数据库中。

结果

主要终点显示,住院期间或术后前30天内未发生吻合口漏。采用圆形机械胃空肠吻合术的SILS胃旁路手术是可行的,且似乎是安全的。

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