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在腹腔镜胃旁路手术中,与圆形吻合器胃空肠吻合术相比,线性吻合器胃空肠吻合术导致的狭窄更少。

Linear stapled gastrojejunostomy results in fewer strictures compared to circular stapled gastrojejunostomy in laparoscopic gastric bypass surgery.

作者信息

Vines Larissa, Frick Thomas, Aczél Stefan, L'Allemand Dagmar, Borovicka Jan, Schiesser Marc

机构信息

Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Kantonsspital St. Gallen, Rorschacherstrasse 95, 9007, St. Gallen, Switzerland.

Klinik für Endokrinologie, Kantonsspital St. Gallen, Rorschacherstrasse 95, 9007, St. Gallen, Switzerland.

出版信息

Langenbecks Arch Surg. 2017 Sep;402(6):911-916. doi: 10.1007/s00423-017-1598-1. Epub 2017 Jul 8.


DOI:10.1007/s00423-017-1598-1
PMID:28689322
Abstract

PURPOSE: Currently, there are two laparoscopic stapling techniques to perform the gastrojejunostomy in gastric bypass surgery: the linear stapling and circular stapling techniques. The aim of the study was to compare the two techniques regarding postoperative morbidity and weight loss at an accredited bariatric reference center in Switzerland. METHODS: We compared two consecutive cohorts at a single institution between November 2012 and June 2014 undergoing laparoscopic gastric bypass surgery. The frequency of complications and weight loss at 1 year was assessed in 109 patients with the 21-mm circular stapling technique (CSA) and 134 patients with the linear stapling technique (LSA). RESULTS: Postoperative complications were more frequent in the CSA group with 23.9 versus 4.5% in the LSA group (p = <0.0001). The main difference was the frequency of strictures, which occurred in 15.6% in the CSA group versus 0% in the LSA group. As a result, endoscopic dilation was required at least once in 15 patients. There was no statistically significant difference in percentage of excessive weight loss (EWL) in both groups; EWL was 74% in the CSA group and 73% in the LSA group (p = 0.68). CONCLUSION: Linear stapled laparoscopic gastric bypass had fewer stenotic strictures with similar weight loss at 1 year compared to circular stapling technique.

摘要

目的:目前,在胃旁路手术中进行胃空肠吻合术有两种腹腔镜吻合技术:直线吻合技术和圆形吻合技术。本研究的目的是在瑞士一家经认可的肥胖症参考中心比较这两种技术在术后发病率和体重减轻方面的差异。 方法:我们比较了2012年11月至2014年6月在同一机构接受腹腔镜胃旁路手术的两个连续队列。对109例采用21毫米圆形吻合技术(CSA)的患者和134例采用直线吻合技术(LSA)的患者在1年时的并发症发生率和体重减轻情况进行了评估。 结果:CSA组术后并发症更为常见,分别为23.9%和4.5%(p = <0.0001)。主要差异在于狭窄的发生率,CSA组为15.6%,而LSA组为0%。结果,15例患者至少需要进行一次内镜扩张。两组在超重减轻百分比(EWL)方面无统计学显著差异;CSA组的EWL为74%,LSA组为73%(p = 0.68)。 结论:与圆形吻合技术相比,直线吻合腹腔镜胃旁路术在1年时狭窄性狭窄较少,体重减轻情况相似。

相似文献

[1]
Linear stapled gastrojejunostomy results in fewer strictures compared to circular stapled gastrojejunostomy in laparoscopic gastric bypass surgery.

Langenbecks Arch Surg. 2017-9

[2]
Anastomotic Stricture Rates Following Roux-en-Y Gastric Bypass for Morbid Obesity: A Comparison Between Linear and Circular-Stapled Anastomosis.

J Laparoendosc Adv Surg Tech A. 2018-6

[3]
Linear vs. circular-stapled gastrojejunostomy in Roux-en-Y gastric bypass.

Surg Endosc. 2019-2-25

[4]
The Effect of Route of Anvil Insertion on Stricture Rates with Circular Stapled Gastrojejunostomy During Laparoscopic Gastric Bypass.

Obes Surg. 2016-3

[5]
Linear-stapled gastrojejunostomy with transverse hand-sewn enterotomy closure significantly reduces strictures for laparoscopic Roux-en-Y gastric bypass.

Obes Surg. 2013-8

[6]
Circular- vs. linear-stapled gastrojejunostomy in laparoscopic Roux-en-Y gastric bypass.

Obes Surg. 2009-10-24

[7]
Gastrojejunostomy stricture rate: comparison between antecolic and retrocolic laparoscopic Roux-en-Y gastric bypass.

Surg Obes Relat Dis. 2015

[8]
Results of gastrojejunal anastomotic technique designed to reduce stricture.

Surg Obes Relat Dis. 2009

[9]
Weight loss and weight regain-5-year follow-up for circular- vs. linear-stapled gastrojejunostomy in laparoscopic Roux-en-Y gastric bypass.

Obes Surg. 2013-6

[10]
Comparison of hand-sewn, linear-stapled, and circular-stapled gastrojejunostomy in laparoscopic Roux-en-Y gastric bypass.

Obes Surg. 2011-11

引用本文的文献

[1]
Long-Term Results of Linear Versus Circular Stapled Gastrojejunostomy in Gastric Bypass Surgery: A Propensity Score-Adjusted Analysis of Weight Loss and Morbidity.

Obes Surg. 2025-4-26

[2]
Comparative analysis of linear- and circular-stapled gastrojejunostomies in Roux-en-Y gastric bypass: a focus on postoperative morbidity using the comprehensive complication index.

Langenbecks Arch Surg. 2024-4-11

[3]
Hand-Sewn Gastrojejunostomy In Situ to Solve Acute Anastomotic Stricture Due to Submucosal Tunneling in Gastric Bypass.

Obes Surg. 2023-5

[4]
Improved Clinical and Financial Outcomes in Proximal Gastric Bypass Surgery Following the Transition from a Conventional Circular Stapling to an Augmented Linear Stapling Protocol.

Obes Surg. 2022-5

[5]
Minimally Invasive Versus open AbdominoThoracic Esophagectomy for esophageal carcinoma (MIVATE) - study protocol for a randomized controlled trial DRKS00016773.

Trials. 2021-1-11

[6]
Is it the technique or wound protection that is key to reducing wound infections in Roux-en-Y gastric bypass procedures?

Surg Endosc. 2020-5

[7]
Systematic Review and Meta-analysis of Circular- and Linear-Stapled Gastro-jejunostomy in Laparoscopic Roux-en-Y Gastric Bypass.

Obes Surg. 2019-6

[8]
Anastomotic Strictures After Roux-en-Y Gastric Bypass: a Cohort Study from the Scandinavian Obesity Surgery Registry.

Obes Surg. 2019-1

本文引用的文献

[1]
Comparison of stricture rates using three different gastrojejunostomy anastomotic techniques in laparoscopic Roux-en-Y gastric bypass.

Surg Endosc. 2015-7

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Obes Surg. 2014-4

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Obes Surg. 2011-11

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Obes Surg. 2009-10-24

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Surg Endosc. 2006-7

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