Vines Larissa, Frick Thomas, Aczél Stefan, L'Allemand Dagmar, Borovicka Jan, Schiesser Marc
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.
Langenbecks Arch Surg. 2017 Sep;402(6):911-916. doi: 10.1007/s00423-017-1598-1. Epub 2017 Jul 8.
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.
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。
J Laparoendosc Adv Surg Tech A. 2018-6
Surg Endosc. 2019-2-25
Surg Obes Relat Dis. 2009