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腹腔镜袖状胃切除术后倾倒综合征的发生率及与腹腔镜Roux-en-Y胃旁路术的比较。

Prevalence of Dumping Syndrome After Laparoscopic Sleeve Gastrectomy and Comparison with Laparoscopic Roux-en-Y Gastric Bypass.

作者信息

Ahmad Arif, Kornrich Daphne Baldwin, Krasner Helaine, Eckardt Sarah, Ahmad Zoha, Braslow AnnaMarie, Broggelwirth Barbara

机构信息

Mather Hospital Northwell Health, 625 Belle Terre Road, Port Jefferson, NY, 11777, USA.

出版信息

Obes Surg. 2019 May;29(5):1506-1513. doi: 10.1007/s11695-018-03699-y.

Abstract

BACKGROUND

Dumping syndrome is a well-known side effect of laparoscopic gastric bypass (LRYGB), and it is commonly believed that dumping syndrome is less likely to occur after laparoscopic sleeve gastrectomy (LSG), due to the preservation of the pyloric sphincter. However, it is not uncommon for patients undergoing LSG at our center to report symptoms suggestive of dumping syndrome.

OBJECTIVE

To assess the prevalence of symptoms of dumping syndrome after LSG compared with LRYGB.

SETTING

A single surgical group at a high-volume (700 cases per year) Bariatric and Metabolic Surgery Center of Excellence.

METHODS

One thousand four hundred seventy-one LRYGB (366) and LSG (1105) patients received a questionnaire to assess symptoms of dumping syndrome, utilizing a modified version of the Sigstad scoring system. Dumping syndrome was considered to be present when the questionnaire score exceeded a threshold value.

RESULTS

A total of 360 responses were received (249 LSG, 111 LRYGB). 26.5% (66) LSG and 41.4% (46) LRYGB exceeded the threshold for dumping syndrome (p < 0.01). 84.8% (56) LSG and 84.7% (39) LRYGB reported early dumping syndrome (p > 0.05). Thirty-six percent (24) LSG and 28% (13) LRYGB reported late dumping syndrome (p > 0.05). Twenty-seven percent (62) LSG and 44.4% (44) LRYGB reported at least one symptom of dumping syndrome with sweets (p < 0.05). 34.3% (85) LSG and 35.5% (39) LRYGB reported symptoms when drinking with or within 30 min of a meal (p > 0.05). 14.5% (36) LSG and 17.3% (19) LRYGB reported symptoms after alcohol consumption (p > 0.05).

CONCLUSION

Dumping syndrome after LSG is prevalent but has not been widely reported. This finding may impact clinicians and patients in their choice of procedure and has relevance in post-operative education and care.

摘要

背景

倾倒综合征是腹腔镜胃旁路术(LRYGB)一种广为人知的副作用,人们普遍认为,由于保留了幽门括约肌,腹腔镜袖状胃切除术(LSG)后倾倒综合征的发生可能性较小。然而,在我们中心接受LSG手术的患者中,报告有倾倒综合征相关症状的情况并不少见。

目的

评估与LRYGB相比,LSG术后倾倒综合征症状的发生率。

地点

一家高容量(每年700例)的卓越减重与代谢手术中心的单一外科团队。

方法

1471例LRYGB(366例)和LSG(1105例)患者收到一份问卷,采用改良版西格斯塔德评分系统评估倾倒综合征症状。当问卷得分超过阈值时,则认为存在倾倒综合征。

结果

共收到360份回复(249例LSG,111例LRYGB)。26.5%(66例)的LSG患者和41.4%(46例)的LRYGB患者超过了倾倒综合征阈值(p<0.01)。84.8%(56例)的LSG患者和84.7%(39例)的LRYGB患者报告有早期倾倒综合征(p>0.05)。36%(24例)的LSG患者和28%(13例)的LRYGB患者报告有晚期倾倒综合征(p>0.05)。27%(62例)的LSG患者和44.4%(44例)的LRYGB患者报告至少有一种食用甜食后的倾倒综合征症状(p<0.05)。34.3%(85例)的LSG患者和35.5%(39例)的LRYGB患者报告在进餐时或进餐后30分钟内饮水时有症状(p>0.05)。14.5%(36例)的LSG患者和17.3%(19例)的LRYGB患者报告饮酒后有症状(p>0.05)。

结论

LSG术后倾倒综合征很常见,但尚未得到广泛报道。这一发现可能会影响临床医生和患者在手术方式上的选择,并与术后教育及护理相关。

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