Obesity Center NRW- Adipositaszentrum NRW, Sana Kliniken, Krankenhausstraße 42, 50354, Hürth, Germany.
Department of Obesity and Metabolic Surgery, Sana Klinikum Offenbach, Offenbach, Germany.
Obes Surg. 2020 May;30(5):1753-1760. doi: 10.1007/s11695-020-04398-3.
Candy cane syndrome (CCS), which is also called Roux syndrome, is a rarely reported and neglected complication of proximal Roux-en-Y gastric bypass (RYGB) surgery.
Forty-seven cases of CCS that underwent candy cane (CC) resection were analyzed retrospectively for pain remission to determine whether intussusception is a possible underlying mechanism.
Forty-three patients (89.6%) benefited from laparoscopic CC resection (p < 0.001). The highly sensitive diagnostic tests were upper gastrointestinal series (91%) and gastroscopy (96%). Intussusception of the CC into the gastric pouch was demonstrated in most cases and was postulated as the trigger for CCS. In some cases, retroperistaltic intussusception led to nonspecific upper gastrointestinal bleeding.
A vast majority of CCS cases benefited significantly from CC resection. The long-described retroperistaltic intussusception of the CC was suggested as an important underlying mechanism of the symptoms. Although CC resection remains a stopgap, evidence on its clinical significance has been shown for a century. Building on this wealth of experience and the already vast storage of practical knowledge, awareness of this underestimated complication after RYGB should be raised.
糖果棒综合征（CCS），也称为 Roux 综合征，是近端 Roux-en-Y 胃旁路（RYGB）手术后一种罕见且被忽视的并发症。
回顾性分析了 47 例接受糖果棒（CC）切除术的 CCS 病例，以确定肠套叠是否是一种可能的潜在机制，以评估疼痛缓解情况。
43 例患者（89.6%）从腹腔镜 CC 切除中获益（p<0.001）。高度敏感的诊断测试包括上消化道造影（91%）和胃镜检查（96%）。大多数情况下，CC 向胃袋内套叠的情况得到了证实，这被认为是 CCS 的触发因素。在某些情况下，逆蠕动肠套叠导致非特异性上消化道出血。
绝大多数 CCS 患者从 CC 切除中显著获益。长期描述的 CC 逆蠕动肠套叠被认为是症状的重要潜在机制。尽管 CC 切除仍然是一种权宜之计，但一个世纪以来，其在临床上的重要性已经得到了证实。在此基础上，基于丰富的经验和已经大量的实践知识，应该提高对 RYGB 后这种被低估的并发症的认识。
