Department of Bariatric Surgery, Orlando Regional Medical Center, Orlando Health, Orlando, Florida.
Department of Bariatric Surgery, Orlando Regional Medical Center, Orlando Health, Orlando, Florida.
Surg Obes Relat Dis. 2017 Nov;13(11):1830-1834. doi: 10.1016/j.soard.2017.01.013. Epub 2017 Jan 9.
Laparoscopic sleeve gastrectomy (LSG) can be performed after obesity persistence following laparoscopic adjustable gastric banding (LAGB) with a positive safety profile. However, some argue that the conversion should be performed in 2 stages rather than 1 because of perioperative complications. The aim of this study is to determine the safety profile of single-stage LAGB to LSG conversion.
Academic hospital, United States.
From October 2009 to July 2016, a total of 76 patients underwent conversions to a LSG because of obesity persistence after LAGB. Of these cases, 65 were done as single-stage procedures and 11 were done in 2 stages. Perioperative complications were compared between the 1-stage and 2-stage conversion groups.
Mean operative time was 122.5±26.1 minutes (range, 75-186) in the single-stage group and 103.6±29.7 minutes (range, 66-145) in the 2-stage group (P>0.08). Mean length of hospital stay was 1.5±.6 days (range, 1-3) in the single-stage group and 1.6±.7 days (range, 1-3) in the 2-stage group (sleeve gastrectomy portion) (P> .58). Two patients (3.1%) in the single-stage group required readmission within 60 days after the conversion because of dehydration (n = 1) and abdominal wall cellulitis (n = 1). Both patients were treated conservatively, and no patient in the 2-stage group required readmission within 60 days from LSG. No patient required reoperation within 60 days, and no patient developed a staple line leakage during the period of follow-up.
Single-stage laparoscopic conversion of LAGB to LSG is feasible and, in appropriately selected patients, does not seem to increase the risk of complications compared with 2-stage procedures.
腹腔镜可调节胃束带术（LAGB）后肥胖持续存在时，可以进行腹腔镜袖状胃切除术（LSG），且具有积极的安全性。然而，一些人认为，由于围手术期并发症，转换应分 2 阶段进行，而不是 1 阶段。本研究旨在确定 LAGB 至 LSG 转换的单阶段 LSG 的安全性概况。
美国学术医院。
从 2009 年 10 月至 2016 年 7 月，共有 76 例患者因 LAGB 后肥胖持续存在而接受 LSG 转换。其中，65 例为单阶段手术，11 例为 2 阶段手术。比较单阶段和 2 阶段转换组的围手术期并发症。
单阶段组的平均手术时间为 122.5±26.1 分钟（范围 75-186），2 阶段组为 103.6±29.7 分钟（范围 66-145）（P>0.08）。单阶段组的平均住院时间为 1.5±0.6 天（范围 1-3），2 阶段组为 1.6±0.7 天（范围 1-3）（LSG 部分）（P>0.58）。单阶段组中有 2 例（3.1%）患者在转换后 60 天内因脱水（n=1）和腹壁蜂窝织炎（n=1）需要再次入院。这 2 例患者均接受保守治疗，2 阶段组无患者在 LSG 后 60 天内需要再次入院。60 天内无患者需要再次手术，随访期间无患者发生吻合口漏。
LAGB 至 LSG 的单阶段腹腔镜转换是可行的，在适当选择的患者中，与 2 阶段手术相比，似乎不会增加并发症的风险。
