腹腔镜Roux-en-Y胃旁路术中直线型与圆形吻合器行胃空肠吻合术：211例病例分析
Linear versus Circular Stapler for Gastrojejunal Anastomosis in Laparoscopic Roux-En-Y Gastric Bypass: An Analysis of 211 Cases.
作者信息
Burla Laurin, Weibel Pascal, Baum Cornelia, Huber Markus, Gürtler Thomas, Weber Markus
机构信息
Department of Visceral, Thoracic and Vascular Surgery, Triemli Hospital, Birmensdorferstrasse 497, Zurich 8063, Switzerland.
出版信息
Surg Res Pract. 2020 Jul 30;2020:4090797. doi: 10.1155/2020/4090797. eCollection 2020.
PURPOSE
Although laparoscopic Roux-en-Y gastric bypass (LRYGB) is a frequently performed bariatric procedure, there is still no consensus on its technical implementation.
METHODS
211 patients treated with LRYGB in a single institution between March 2011 and October 2016 were analyzed retrospectively. A subgroup analysis for the linear (LSA) versus circular stapler technique (CSA) for gastrojejunal anastomosis (GJA) was performed to evaluate complications and outcomes.
RESULTS
128 (60.6%) patients received GJA with CSA and 83 (39.4%) with LSA. Average weight loss one year after surgery, respectively, BMI after one year of follow-up (kg/m), showed no significant difference. Median surgery time was significantly shorter in the LSA group. If the procedure was performed with CSA, significantly more wound infections occurred.
CONCLUSIONS
Both the circular and the linear stapler techniques for gastrojejunal anastomosis in laparoscopic Roux-en-Y gastric bypass are safe methods with comparable outcomes. A disadvantage of CSA is the significantly higher rate of wound infections, a circumstance which requires increased attention.
目的
尽管腹腔镜Roux-en-Y胃旁路术（LRYGB）是一种常施行的减肥手术，但其技术实施仍未达成共识。
方法
回顾性分析2011年3月至2016年10月在单一机构接受LRYGB治疗的211例患者。对胃空肠吻合术（GJA）采用直线型（LSA）与圆形吻合器技术（CSA）进行亚组分析，以评估并发症和结局。
结果
128例（60.6%）患者采用CSA进行GJA，83例（39.4%）采用LSA。术后一年的平均体重减轻，以及随访一年后的BMI（kg/m），均无显著差异。LSA组的中位手术时间显著更短。若采用CSA进行手术，伤口感染发生率显著更高。
结论
腹腔镜Roux-en-Y胃旁路术中胃空肠吻合术采用圆形和直线型吻合器技术均为安全方法，结局相似。CSA的一个缺点是伤口感染率显著更高，这一情况需要更多关注。
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