Department of Bariatric and Metabolic Surgery, Weight Loss Center, The Brooklyn Hospital Center, Icahn School of Medicine at Mount Sinai, 121 DeKalb Ave, Brooklyn, NY, 11201, USA.
Metabolic & Bariatric Surgery Department, Hamad Medical Corporation, Weill Cornell Medical College, Doha, Qatar.
Surg Endosc. 2017 Dec;31(12):4883-4887. doi: 10.1007/s00464-017-5434-z. Epub 2017 Mar 24.
Laparoscopic sleeve gastrectomy (LSG) has become a popular stand-alone treatment for morbid obesity. However, removal of the gastric specimen could be a challenging step due to its large size relative to the width of the trocar site.
We aimed to compare a simplified retrieval technique for extraction of the gastric specimen without an endobag with conventionally performed specimen retrieval using an endobag.
A case-control study was conducted recruiting patients undergoing LSG. Patient's demographics, preoperative characteristics, intra-operative, and postoperative variables were compared between the two groups according to the technique of gastric specimen removal.
A total of 193 patients (60.6% female) were enrolled into case (n = 100) and control groups (n = 93). Mean ± SD age and BMI of patients were 35.64 ± 11.84 years and 47.28 ± 8.22 Kg/m, respectively with no significant difference between groups. Median (25th, 75th inter-quartile), extraction time was significantly reduced in the non-endobag group compared to the endobag group (3.5 [2.5-4.5] min vs. 6.5 [3.4-8.2] min, p = 0.03).Patients of both groups had similar intra-operative and trocar site complications (hernia and wound infection) (3% for endobag group and 3.3 % for non-endobag group). The median (25-75% [IQR]) LOS was also comparable between endobag and non-endobag patients (3[2-3] vs. 3[2-4] days, p = 0.84). No difference was observed between the two groups for weight loss and comorbidity resolution.
Non-endobag technique for gastric specimen retrieval is safe and feasible with substantial saving in operative time and comparable intra-operative and postoperative outcomes to the conventional retrieval technique.
腹腔镜袖状胃切除术（LSG）已成为治疗病态肥胖的一种流行的独立治疗方法。然而，由于胃标本的体积相对于套管部位的宽度较大，因此取出胃标本可能是一个具有挑战性的步骤。
我们旨在比较一种简化的胃标本取出技术，该技术无需使用内镜袋即可取出胃标本，而传统的标本取出方法则需要使用内镜袋。
进行了一项病例对照研究，招募了接受 LSG 的患者。根据胃标本取出技术，比较了两组患者的人口统计学、术前特征、术中及术后变量。
共有 193 例患者（60.6%为女性）纳入病例组（n=100）和对照组（n=93）。患者的平均年龄为 35.64±11.84 岁，BMI 为 47.28±8.22 Kg/m，两组之间无显著差异。非内镜袋组的中位（25 分位，75 分位）提取时间明显短于内镜袋组（3.5[2.5-4.5]min 比 6.5[3.4-8.2]min，p=0.03）。两组患者的术中及套管部位并发症（疝和伤口感染）发生率相似（内镜袋组为 3%，非内镜袋组为 3.3%）。内镜袋组和非内镜袋组的中位（25%-75%[IQR]）住院时间也相似（3[2-3]天比 3[2-4]天，p=0.84）。两组患者的体重减轻和合并症缓解情况无差异。
非内镜袋胃标本取出技术安全可行，可显著缩短手术时间，与传统的标本取出技术相比，术中及术后结果相当。
