Giuliani Antonio, Romano Lucia, Papale Eleonora, Puccica Ilaria, Di Furia Marino, Salvatorelli Andrea, Cianca Giovanni, Schietroma Mario, Amicucci Gianfranco
Department of Surgery, University of L'Aquila, L'Aquila, Italy.
Department of Surgery, University of L'Aquila, L'Aquila, Italy -
Minerva Chir. 2019 Jun;74(3):213-217. doi: 10.23736/S0026-4733.19.07883-0. Epub 2019 Feb 13.
Laparoscopic sleeve gastrectomy (LSG) has become a very frequent procedure in bariatric surgery. Despite its simplicity, it can have serious complications. Among these, gastric leak is one of the most feared complications. Numerous intraoperative maneuvers have been suggested in an attempt to decrease the incidence of leak. In our center, we decided to study one of the intraoperative measures proposed, which consists in positioning the suture machine to 1.5 cm from His corner.
This retrospective study reported 101 cases of LSG performed in our center from 2012 to 2017. The patients were divided into two groups, with comparable anthropometric parameters and comparable inclusion criteria. In the two groups the operative technique used was the same, except for a maneuver: in the second group, attention was paid to keep a distance from the angle of at least 1.5 cm.
On a total of 101 procedures performed, the overall complication rate was 4,95%. In group 1 the rate of gastric staple line leak was 6.78%. In group 2 the rate was 2.38%.
The analyzed surgical technique seems to decrease the risk of leak without significantly impacting weight loss, and we have noticed in our clinical experience a decrease in the incidence of fistula from the time this measure was adopted. Also the statistical analysis encourage the continuation of experimentation.
腹腔镜袖状胃切除术（LSG）已成为减肥手术中非常常见的术式。尽管其操作简单，但仍可能出现严重并发症。其中，胃漏是最令人担忧的并发症之一。为降低漏出发生率，人们提出了许多术中操作方法。在我们中心，我们决定研究其中一种术中措施，即将缝合器放置在距His角1.5厘米处。
这项回顾性研究报告了2012年至2017年在我们中心进行的101例LSG病例。患者被分为两组，人体测量参数和纳入标准相当。两组的手术技术相同，除了一个操作：在第二组中，注意保持距角至少1.5厘米的距离。
在总共进行的101例手术中，总体并发症发生率为4.95%。第一组胃吻合钉线漏出率为6.78%。第二组的发生率为2.38%。
所分析的手术技术似乎降低了漏出风险，且对体重减轻无显著影响，并且我们在临床经验中注意到，自采用该措施以来，瘘管发生率有所下降。统计分析也鼓励继续进行实验。
