Park Ji Yeon, Kim Yong Jin
Department of Surgery, Soonchunhyang University Seoul Hospital, 59, Daesagwan-ro, Yongsan-gu, 140-743, Seoul, Republic of Korea,
Surg Today. 2015 Aug;45(8):1032-9. doi: 10.1007/s00595-014-1097-8. Epub 2014 Dec 18.
Roux-en-Y gastric bypass (RYGB) is thought to be the gold standard treatment for morbid obesity. However, concerns have been raised by investigators in areas where gastric cancer is prevalent regarding the inaccessibility of the excluded stomach to regular surveillance. This study aimed to evaluate the technical feasibility and short-term surgical outcomes of resectional RYGB.
Sixteen consecutive patients who underwent laparoscopic gastric bypass with distal gastric resection for the primary purpose of weight loss between January 2011 and December 2013 were retrospectively reviewed. The perioperative outcomes and weight loss results of these patients were analyzed.
All procedures were successfully performed laparoscopically. The mean length of the operation and the mean hospital stay were 170 min (range 110-225) and 4 days (range 2-7), respectively. The prevalence of early postoperative complications reached 18.7% after resectional RYGB, but a severe complication requiring reoperation occurred in only one patient (6.3%). The percent of excess weight loss was 78.9% over a mean follow-up period of 14 months. Obesity-related comorbidities including diabetes, hypertension and dyslipidemia resolved or improved after surgery in most patients.
Resectional RYGB is technically feasible and can be a viable option in countries with a high risk of gastric cancer, where surgeons are already well trained in laparoscopic gastrectomy.
Roux-en-Y胃旁路术（RYGB）被认为是治疗病态肥胖的金标准。然而，在胃癌高发地区，研究人员对被旷置胃难以进行常规监测表示担忧。本研究旨在评估切除性RYGB的技术可行性和短期手术效果。
回顾性分析2011年1月至2013年12月期间连续16例因减重为主接受腹腔镜胃旁路术加远端胃切除术的患者。分析这些患者的围手术期结果和减重效果。
所有手术均成功通过腹腔镜完成。平均手术时长和平均住院时间分别为170分钟（范围110 - 225分钟）和4天（范围2 - 7天）。切除性RYGB术后早期并发症发生率达18.7%，但仅1例患者（6.3%）出现需要再次手术的严重并发症。平均随访14个月期间，超重减轻百分比为78.9%。大多数患者术后肥胖相关合并症包括糖尿病、高血压和血脂异常得到缓解或改善。
切除性RYGB在技术上是可行的，对于胃癌高危国家而言可能是一种可行选择，这些国家的外科医生已接受过良好的腹腔镜胃切除术培训。
