Al Amiri Hospital, Kuwait City, Kuwait.
Department of Medicine, Faculty of Medicine, Kuwait University, Kuwait City, Kuwait.
Surg Endosc. 2017 Sep;31(9):3559-3563. doi: 10.1007/s00464-016-5385-9. Epub 2016 Dec 28.
Laparoscopic sleeve gastrectomy (LSG) is becoming an increasingly popular form of bariatric surgery, accounting for more than 50% of these procedures performed in the USA. Given this popularity, more is being understood about the complications associated with LSG, which, though uncommon, include the formation of strictures and stenosis. The purpose of this study is to establish a safe and effective protocol for the treatment of stenosis post-LSG using endoscopic balloon dilatation.
This is a prospective review of 26 patients who had undergone LSG in Kuwait, followed by sleeve gastrectomy stenosis (SGS) and were then referred to Amiri Hospital for endoscopic balloon dilatation from October 2008 up to June 2016.
A total of 26 patients (four males; 22 females) presented with symptoms of stenosis post-LSG during the study period. The mean age of the patients was 34.6 ± 10.8 years. The mean body mass index at the time of surgery was 43 ± 1.6 kg/m. The median interval from the initial LSG surgery was 95 days. Nine patients had an early presentation (≤3 months from surgery), while 17 presented late (>3 months). The patients were followed for a mean duration of 156 ± 20 days from the last endoscopic balloon dilatation. A total of 23 (88.5%) patients had complete resolution of their symptoms. Adverse events were observed in one patients, who was removed from the study.
Gastric stenosis is a rare but potentially serious complication of LSG. Serial dilatation of SGS employing endoscopic balloons is a safe method of treatment, with high efficacy rates. This new method may offer a less invasive alternative to surgical revision. However, if endoscopic treatment fails, surgery is necessary.
腹腔镜袖状胃切除术（LSG）正成为一种越来越受欢迎的减重手术方式，在美国，这种手术方式占比超过 50%。鉴于其普及程度，人们对 LSG 相关并发症的了解也越来越多，其中包括狭窄和梗阻，虽然并不常见。本研究旨在建立一种使用内镜球囊扩张治疗 LSG 后狭窄的安全有效的方案。
这是一项对科威特 26 名患者的前瞻性回顾，这些患者在科威特进行了 LSG 手术，随后出现了袖状胃切除术狭窄（SGS），并于 2008 年 10 月至 2016 年 6 月期间转诊至 Amiri 医院接受内镜球囊扩张治疗。
在研究期间，共有 26 名（4 名男性；22 名女性）患者出现 LSG 术后狭窄症状。患者的平均年龄为 34.6±10.8 岁。手术时的平均体重指数为 43±1.6kg/m。初次 LSG 手术至出现狭窄的中位间隔时间为 95 天。9 例患者（3 个月内）为早期表现，17 例（3 个月后）为晚期表现。从最后一次内镜球囊扩张到随访结束，患者平均随访时间为 156±20 天。23 例（88.5%）患者的症状完全缓解。1 例患者出现不良反应，被排除在研究之外。
胃狭窄是 LSG 的一种罕见但潜在严重的并发症。采用内镜球囊对 SGS 进行连续扩张是一种安全有效的治疗方法，其疗效较高。这种新方法可能为手术修复提供一种创伤较小的替代方法。但是，如果内镜治疗失败，仍需要手术。
