Kalaiselvan Ramya, Ammori Basil J
Department of Upper Gastrointestinal Surgery, Salford Royal Hospital, Manchester, United Kingdom.
Department of Upper Gastrointestinal Surgery, Salford Royal Hospital, Manchester, United Kingdom; The University of Manchester, Manchester, United Kingdom.
Surg Obes Relat Dis. 2015 Mar-Apr;11(2):474-7. doi: 10.1016/j.soard.2014.06.021. Epub 2014 Jul 19.
Laparoscopic sleeve gastrectomy (LSG) has become an established primary bariatric procedure. Gastric stenosis after LSG has been reported in a few studies and often occurs at the level of incisura or midbody because of a technical operative error and could be associated with a leak. This can be managed by endoscopic dilations or revision surgery. The objective of this study is to describe a novel technique to deal with sleeve stenosis and its outcome.
Two patients presented with sleeve stenosis after LSG and underwent a novel technique. The patients were followed up for 18 months.
We describe a novel technique of laparoscopic median gastrectomy in 2 patients that involved resection of the stenotic segment followed by a hand-sewn, gastrogastric, end-to-end anastomosis. Both patients had successfully recovered from stenosis related symptoms, although one required an endoscopic dilation of the anastomosis.
Laparoscopic median gastrectomy is a feasible and effective option in patients who have failed conservative management of stenosis after LSG and in whom there is a desire to avoid seromyotomy or conversion to gastric bypass.
腹腔镜袖状胃切除术（LSG）已成为一种成熟的主要减肥手术。少数研究报道了LSG术后胃狭窄，常因手术技术失误发生在胃切迹或胃体中部水平，且可能与渗漏有关。这可通过内镜扩张或翻修手术处理。本研究的目的是描述一种处理袖状胃狭窄的新技术及其结果。
两名患者在LSG术后出现袖状胃狭窄并接受了一种新技术治疗。对患者进行了18个月的随访。
我们描述了一种对2例患者施行腹腔镜正中胃切除术的新技术，该技术包括切除狭窄段，然后进行手工缝合的胃-胃端端吻合。两名患者均已从狭窄相关症状中成功康复，尽管其中一名患者需要对吻合口进行内镜扩张。
对于LSG术后狭窄保守治疗失败且希望避免浆膜切开术或改行胃旁路术的患者，腹腔镜正中胃切除术是一种可行且有效的选择。
