Ayadi Sofiene, Daghfous Amine, Saidani Ahmed, Haddad Anis, Magherbi Houcine, Jouini Mohamed, Kacem Montassar, Ben Safta Zoubeir
Tunis Med. 2014 Oct;92(10):601-3.
Despite the establishment of effective medical therapies in peptic ulcer disease, gastric outlet obstruction remains one of the most common health problem in Tunisia. Various operations have been attempted, which may lead to postoperative morbidity. Gastrointestinal (GI) motility dysfunction is the most common complications.
to determine the predictive factor of gastrointestinal motility dysfunction after gastrojejunostomy for peptic ulcer stenosis.
We carried out a retrospective study to evaluate the postoperative recovery of the motility of the upper gastrointestinal tract after gastrojejunostomy for peptic ulcer stenosis. During the 9- year study, 138 patients underwent operations for ulcer peptic stenosis. Among the patients, 116 (84,1%) were treated with gastrojejunostomy. Descriptive statistics, univariate and multivariate analyses were performed.
The mean age of patients was 47.85 years (range: 19- 92years) and most. Were male (84, 5 %). Ninety two (79.3%) patients had a documented history of peptic ulcer disease. The duration of symptoms ranged from 10 to 372 days (mean: 135.86 days). Eighty two (71%) patients were operated on through laparotomy. Laparoscopic procedure was performed in 29% of the patients. There was no operative mortality. Perioperative morbidity occurred in 12.4% (14 patients). Gastrointestinal motility dysfunction occurred in 12 patients (10.3%). It was treated by nasogastric aspiration and prokinetics. By univariate analysis; diabetes (0,010), cachexia (0,049), ASA class (0.05) were all statistically associated with gastrointestinal motility dysfunction in this series. Multivariate logistic regression analysis (table 2) showed that the cachexia (0,009), ASA class (0.02) were the main predictors of gastrointestinal motility dysfunction after gastrojejunostomy for peptic ulcer stenosis in the followed patients.
Gastrointestinal motility dysfunction is the most common complications after gastrojejunostomy for pyloric adult stenosis. Surgery must be preceded by careful medical preparation. It is more likely to occur in patients with an ASA class 2 or greater. Those patients should be considered for other treatment options, such as endoscopic balloon dilation.
尽管消化性溃疡疾病已确立了有效的药物治疗方法，但胃出口梗阻仍是突尼斯最常见的健康问题之一。人们尝试了各种手术，这可能导致术后发病。胃肠动力功能障碍是最常见的并发症。
确定消化性溃疡狭窄行胃空肠吻合术后胃肠动力功能障碍的预测因素。
我们进行了一项回顾性研究，以评估消化性溃疡狭窄行胃空肠吻合术后上消化道动力的术后恢复情况。在为期9年的研究中，138例患者接受了溃疡狭窄手术。其中，116例（84.1%）接受了胃空肠吻合术治疗。进行了描述性统计、单因素和多因素分析。
患者的平均年龄为47.85岁（范围：19 - 92岁），大多数为男性（84.5%）。92例（79.3%）患者有消化性溃疡病史记录。症状持续时间为10至372天（平均：135.86天）。82例（71%）患者通过剖腹手术进行手术。29%的患者进行了腹腔镜手术。无手术死亡。围手术期发病率为12.4%（14例患者）。12例患者（占10.3%）出现胃肠动力功能障碍。通过鼻胃吸引和促动力药进行治疗。单因素分析显示，在本系列中，糖尿病（0.010）、恶病质（0.049）、美国麻醉医师协会（ASA）分级（0.05）均与胃肠动力功能障碍有统计学关联。多因素逻辑回归分析（表2）显示，恶病质（0.009）、ASA分级（0.02）是随访患者消化性溃疡狭窄行胃空肠吻合术后胃肠动力功能障碍的主要预测因素。
胃肠动力功能障碍是成人幽门狭窄行胃空肠吻合术后最常见的并发症。手术前必须进行仔细的药物准备。在ASA分级为2级或更高的患者中更易发生。应考虑为这些患者选择其他治疗方案，如内镜球囊扩张术。
