Alhayo Sam, Devadas Michael
Department of Surgery, St George Hospital, NSW Health, Sydney, NSW, Australia.
Department of Surgery, The Sydney University, Sydney, NSW, Australia.
J Surg Case Rep. 2019 Dec 11;2019(12):rjz315. doi: 10.1093/jscr/rjz315. eCollection 2019 Dec.
Endoscopic sleeve gastroplasty (ESG) is a new obesity control modality. Limited data are available to describe post ESG findings and approaches to surgically revise this procedure. Two female patients with persistent obesity despite multiple ESG procedures underwent laparoscopic sleeve gastrectomy (LSG). Pre- and post-ESG, LSG body mass index (BMI), weight, and excess weight loss percentage (EWL%) were recorded. Endoscopic findings and revisional LSG technique were carefully documented. Pre-ESG BMI of the patients were 44 and 52 kg/m. Pre-LSG BMI were 44.6 and 50 kg/m. Pre-LSG gastroscopy and laparoscopy revealed complete dehiscence of ESG sutures with full-thickness invasion of these sutures and titanium clips through the gastric wall and some intraperitoneal adhesions. At 7-month follow-up, BMI are 40.3 and 35.7 kg/m and EWL% are 39 and 43%, respectively. This is the first study reporting LSG following failed ESG. ESG can lead to significant complications. LSG is achievable post-ESG and has superior results to it.
内镜下袖状胃成形术（ESG）是一种新的肥胖控制方式。目前关于ESG术后结果及对该手术进行外科修正方法的可用数据有限。两名女性患者尽管接受了多次ESG手术，但仍持续肥胖，随后接受了腹腔镜袖状胃切除术（LSG）。记录了ESG术前及术后、LSG术后的体重指数（BMI）、体重和超重减轻百分比（EWL%）。仔细记录了内镜检查结果及修正性LSG技术。患者ESG术前BMI分别为44和52kg/m²。LSG术前BMI分别为44.6和50kg/m²。LSG术前胃镜检查和腹腔镜检查显示ESG缝线完全裂开，缝线和钛夹全层穿透胃壁，并伴有一些腹腔内粘连。在7个月的随访中，BMI分别为40.3和35.7kg/m²，EWL%分别为39%和43%。这是第一项报告ESG失败后行LSG的研究。ESG可导致严重并发症。ESG术后可行LSG，且效果优于ESG。
