Lauti Melanie, Gormack Sophie E, Thomas Jeni M, Morrow Jon J, Rahman Habib, MacCormick Andrew D
Department of Surgery, University of Auckland, Auckland, New Zealand.
Department of General Surgery, Middlemore Hospital, Counties Manukau Health, Auckland, New Zealand.
Obes Surg. 2016 Apr;26(4):839-42. doi: 10.1007/s11695-015-1832-2.
Staple-line leak and haemorrhage are the most serious complications following sleeve gastrectomy. The operation is often performed without prior endoscopy. Given that gastric inflammatory conditions are common, could they predispose patients to suffering a serious complication following sleeve gastrectomy?
Consecutive patients undergoing laparoscopic sleeve gastrectomy from March 2007 to May 2014 were included in the study. All final histologic reports were coded and investigated against whether or not the patient had a post-operative leak and/or haemorrhage. Associations were explored using Fisher's exact test.
Over this period, 976 laparoscopic sleeve gastrectomies were performed with a pre-operative gastroscopy rate of 2.2%. Over half of the specimens demonstrated a histopathologic abnormality. Helicobacter pylori infection occurred in 8.6%, and the most common histopathologic abnormality was chronic gastritis in 38.9%. There was no association between H. pylori infection or inflammation and staple-line leak and/or haemorrhage.
We conclude that inflammatory gastric conditions are unlikely to predispose patients to staple-line leaks or haemorrhages following sleeve gastrectomy and that selective pre-operative gastroscopy may be an appropriate standard of care.
吻合口漏和出血是袖状胃切除术后最严重的并发症。该手术通常在未进行术前内镜检查的情况下实施。鉴于胃炎情况常见，它们会使患者在袖状胃切除术后更易发生严重并发症吗？
纳入2007年3月至2014年5月连续接受腹腔镜袖状胃切除术的患者。对所有最终组织学报告进行编码，并调查患者是否发生术后吻合口漏和/或出血。采用Fisher精确检验探索相关性。
在此期间，共进行了976例腹腔镜袖状胃切除术，术前胃镜检查率为2.2%。超过一半的标本显示组织病理学异常。幽门螺杆菌感染率为8.6%，最常见的组织病理学异常是慢性胃炎，占38.9%。幽门螺杆菌感染或炎症与吻合口漏和/或出血之间无相关性。
我们得出结论，胃部炎症情况不太可能使患者在袖状胃切除术后发生吻合口漏或出血，选择性术前胃镜检查可能是合适的治疗标准。
