Braghetto Italo, Martinez Gustavo, Korn Owen, Zamorano Marcelo, Lanzarini Enrique, Narbona Enrique
Department of Surgery, University Hospital, Faculty of Medicine, University of Chile, Santos Dumont 999, Santiago, Chile.
Surg Today. 2018 May;48(5):558-565. doi: 10.1007/s00595-018-1625-z. Epub 2018 Feb 15.
Laparoscopic Roux-en-Y Gastric Bypass (LRYGB) without resection of the distal stomach is largely performed over the world for morbid obesity. Potential risk of gastric remnant carcinoma development has been suggested.
To present the results obtained after LRYGB with resection of distal stomach.
This prospective study includes 400 consecutive patients. The mean body weight was 105.9 ± 16.8 Kg (range 83-145 kg), and body mass index (BMI) was 38.5 ± 4.4 kg/m (32.9-50.3). Postoperative morbid-mortality and follow-up were analyzed.
Operative time was 128.5 ± 18.7 min, hospital discharge occurred at 3rd postoperative day, postoperative complications occurred in 9.25%, early surgical complications were observed in 3% and medical complications 4%, late surgical complications occurred 2.25%, no mortality was observed. At 1 year follow-up, BMI was 25.3 ± 2.7 kg/m with % of weight loss (%WL) of 84.6 + 19.1%. At five years follow-up very similar values were observed.
The results obtained after LRYGB with resection of distal stomach are similar to results published after non resection LRYGB regarding early and late results and can be indicated in high risk areas of gastric carcinoma.
不切除远端胃的腹腔镜Roux-en-Y胃旁路术（LRYGB）在全球范围内广泛用于治疗病态肥胖症。有人提出了胃残余癌发生的潜在风险。
介绍切除远端胃的LRYGB术后的结果。
这项前瞻性研究纳入了400例连续患者。平均体重为105.9±16.8千克（范围83-145千克），体重指数（BMI）为38.5±4.4千克/平方米（32.9-50.3）。分析术后的病死率和随访情况。
手术时间为128.5±18.7分钟，术后第3天出院，术后并发症发生率为9.25%，早期手术并发症发生率为3%，医疗并发症发生率为4%，晚期手术并发症发生率为2.25%，未观察到死亡病例。随访1年时，BMI为25.3±2.7千克/平方米，体重减轻百分比（%WL）为84.6±19.1%。随访5年时观察到非常相似的值。
切除远端胃的LRYGB术后的早期和晚期结果与未切除远端胃的LRYGB术后公布的结果相似，可用于胃癌高危地区。
