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腹腔镜减肥手术后吻合钉线和吻合口的并发症。

Complications of staple line and anastomoses following laparoscopic bariatric surgery.

作者信息

Silecchia Gianfranco, Iossa Angelo

机构信息

Department of Medical-Surgical Sciences and Biotechnologies, Division of General Surgery and Bariatric Centre of Excellence, University of Rome "La Sapienza", Rome, Italy.

出版信息

Ann Gastroenterol. 2018 Jan-Feb;31(1):56-64. doi: 10.20524/aog.2017.0201. Epub 2017 Oct 12.

Abstract

With over 600 million people being obese, and given the scientific demonstration of the advantages of surgical treatment, bariatric surgery is on the rise. The promising long-term results in terms of weight loss, and particularly in relation to comorbidities and the control/cure rate, mean that the number of procedures performed in all countries remains high. However, the risk of potentially complex or fatal complications, though small, is present and is related to the procedures . This review is a guide for bariatric and/or general surgeons, offering a complete overview of the pathogenesis of anastomosis and staple line following the most common laparoscopic bariatric procedures: sleeve gastrectomy, gastric bypass, and mini-gastric bypass. The review is divided according to the procedure and the complications (leak, bleeding and stenosis), and evaluates all the factors that can potentially improve or worsen the complication rate, representing a "unicum" in the present literature on bariatric surgery.

摘要

全球有超过6亿人肥胖,鉴于手术治疗优势的科学证明,减肥手术正在兴起。减肥手术在减重方面,尤其是在合并症以及控制/治愈率方面有着令人期待的长期效果,这意味着所有国家实施的手术数量一直居高不下。然而,尽管潜在的复杂或致命并发症风险很小,但仍然存在,且与手术操作有关。本综述是为减肥外科医生和/或普通外科医生提供的指南,全面概述了最常见的腹腔镜减肥手术(袖状胃切除术、胃旁路手术和迷你胃旁路手术)后吻合口和吻合钉线的发病机制。该综述根据手术方式和并发症(渗漏、出血和狭窄)进行划分,并评估了所有可能提高或降低并发症发生率的因素,在目前关于减肥手术的文献中堪称独一无二。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a8c8/5759613/26eb65974be7/AnnGastroenterol-31-56-g001.jpg

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