Gomberawalla Ameer, Salamat Arsalan, Lutfi Rami
Saint Joseph Hospital, Chicago Institute of Advanced Bariatric Surgery, 2900 N Lake Shore Drive, Chicago, IL, 60657, USA,
Obes Surg. 2014 Nov;24(11):1870-4. doi: 10.1007/s11695-014-1312-0.
Single incision laparoscopy remains controversial due to technical challenges which may cause suboptimal outcomes. This study aims to evaluate the feasibility and equivalency of the single incision sleeve gastrectomy (SISG) when compared to the traditional multiport sleeve gastrectomy (MPSG) approach in a matched cohort evaluating technical aspects and postoperative results.
This is a retrospective analysis of prospectively collected data in a consecutive cohort of 113 SG (MPSG = 77, SISG = 36). The 36 patients who underwent SISG were included as the case group. Thirty-six MPSG patients were included in the control group, in 1:1 ratio with cases after matching for BMI, age, race, gender, and additional demographic data. Operative time (OT) in minutes and length of stay (LOS) in days was measured and excess weight loss (EWL) at 6 months and 1 year was collected and evaluated.
Mean BMI was equivalent (SISG 43.06, MPSG 43.72, p = 0.36). Mean OT for the SISG was 116.78 and 118.25 for the MPSG (p = 0.84), and mean LOS was 1.80 for the SISG and 1.75 for the MSPG (p = 0.75). EWL at 6 months was 58.4 % for the SISG and 58.5 % for the MPSG (p = 0.98) and 72.3 and 74.1 % (p = 0.77) for 1 year, respectively. There were no leaks in either group. There was one reoperation for postoperative bleeding in the MPSG group.
Sleeve gastrectomy can be performed safely using single incision techniques with equivalent outcomes for weight loss.
由于技术挑战可能导致效果欠佳，单切口腹腔镜手术仍存在争议。本研究旨在评估单切口袖状胃切除术（SISG）与传统多端口袖状胃切除术（MPSG）相比在匹配队列中的可行性和等效性，评估技术方面和术后结果。
这是一项对前瞻性收集的连续113例袖状胃切除术患者（MPSG = 77例，SISG = 36例）数据的回顾性分析。接受SISG的36例患者作为病例组。36例MPSG患者作为对照组，在匹配BMI、年龄、种族、性别和其他人口统计学数据后与病例组按1:1比例纳入。测量手术时间（OT，分钟）和住院时间（LOS，天），并收集和评估6个月和1年时的超重减轻（EWL）情况。
平均BMI相当（SISG为43.06，MPSG为43.72，p = 0.36）。SISG的平均OT为116.78分钟，MPSG为118.25分钟（p = 0.84），SISG的平均LOS为1.80天，MSPG为1.75天（p = 0.75）。6个月时SISG的EWL为58.4%，MPSG为58.5%（p = 0.98），1年时分别为72.3%和74.1%（p = 0.77）。两组均无渗漏。MPSG组有1例因术后出血再次手术。
使用单切口技术进行袖状胃切除术可安全实施，减重效果相当。
