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使用合成生物可吸收吻合线加固材料的腹腔镜袖状胃切除术:术后并发症及6年随访结果

Laparoscopic sleeve gastrectomy using a synthetic bioabsorbable staple line reinforcement material: Post-operative complications and 6 year outcomes.

作者信息

Saleh Mahdi, Cheruvu Manikandar S, Moorthy Krishna, Ahmed Ahmed R

机构信息

School of Medicine, Imperial College, London, UK.

Bariatric Surgery Department, Imperial College Healthcare NHS Trust, London, UK.

出版信息

Ann Med Surg (Lond). 2016 Aug 9;10:83-7. doi: 10.1016/j.amsu.2016.08.005. eCollection 2016 Sep.

Abstract

BACKGROUND

Gastric leak after laparoscopic sleeve gastrectomy (LSG) is a serious complication. Currently, the literature lacks long-term outcomes in LSG and leak rates after reinforcement of the staple line. The aims are two-fold: to present leak rates from using staple line reinforcement and six year outcomes of LSG in relation to resolution of obesity-related comorbidities and long-term weight loss.

MATERIALS AND METHODS

This is a single-institution, retrospectively reviewed study of 204 patient case files. Data from all patients undergoing LSG between December 2007 and May 2013 was collected.

RESULTS

The total complication rate was 6.9% (14/204), with no recorded staple line leaks. The mean postoperative Body Mass Index (BMI) at 1 year, 2 years, 3 years, 4 years, 5 years, and 6 years was 39.3 ± 8, 38.7 ± 8, 40.4 ± 9, 40.5 ± 10, 43.0 ± 10, and 42.4 ± 7, respectively. The mean % excess weight loss at 1 year, 3 years, and 6 years was 48.4 ± 19, 51.7 ± 28, and 41.0 ± 21, respectively. There were no significant differences between follow-ups at year 1 and 3 (p > 0.05), and between year 3 and 6 (p > 0.05) for the mean % excess weight loss. The resolution rates for all patients were 74%, 61%, 79%, and 90% for hypertension, hypercholesterolemia, diabetes mellitus type 2 and obstructive sleep apnea, respectively.

CONCLUSION

The synthetic bioabsorbable reinforcement material shows no staple line leaks making it safe to use. LSG as a procedure had a high resolution of obesity-related comorbidities as well as sustainable long-term weight loss.

摘要

背景

腹腔镜袖状胃切除术(LSG)后胃漏是一种严重的并发症。目前,文献中缺乏LSG的长期结果以及吻合钉线加固后的漏出率。目的有两个:呈现使用吻合钉线加固后的漏出率以及LSG在解决肥胖相关合并症和长期体重减轻方面的六年结果。

材料与方法

这是一项对204例患者病例档案进行单机构回顾性研究。收集了2007年12月至2013年5月期间所有接受LSG患者的数据。

结果

总并发症发生率为6.9%(14/204),未记录到吻合钉线漏。术后1年、2年、3年、4年、5年和6年的平均体重指数(BMI)分别为39.3±8、38.7±8、40.4±9、40.5±10、43.0±10和42.4±7。1年、3年和6年的平均超重体重减轻百分比分别为48.4±19、51.7±28和41.0±21。1年和3年随访之间(p>0.05)以及3年和6年随访之间(p>0.05)的平均超重体重减轻百分比无显著差异。所有患者中高血压、高胆固醇血症、2型糖尿病和阻塞性睡眠呼吸暂停的缓解率分别为74%、61%、79%和90%。

结论

合成生物可吸收加固材料未出现吻合钉线漏,使用安全。LSG作为一种手术方法,对肥胖相关合并症有较高的缓解率,且能实现可持续的长期体重减轻。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b26c/4995473/a1d3dff7453f/gr1.jpg

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