Department of Health Sciences, Nişantaşi University.
Türkçapar Bariatrics, Obesity Center.
Surg Laparosc Endosc Percutan Tech. 2020 Oct 29;31(2):220-222. doi: 10.1097/SLE.0000000000000869.
The aim of this study is to determine whether gastric sleeve fixation prevents functional stenosis (twist or kink) and to investigate its effects on symptoms such as nausea and vomiting after laparoscopic sleeve gastrectomy (LSG).
A total of 717 patients who underwent primary LSG for morbid obesity and completed at least 1 year of follow-up between 2012 and 2019 were included in the study. All operations were performed by the same surgical team using the same technique. The patients were divided into 2 groups, that is, group 1: standard LSG and group 2: gastric sleeve fixation with LSG. These 2 groups were compared in terms of demographic characteristics, baseline body mass index, follow-up duration, bleeding, leaks, gastric stenosis, postoperative nausea, vomiting, and the need for antiemetics. In the follow-up period, patients with suspected gastric stenosis underwent endoscopy and upper gastrointestinal series.
LSG was performed in 717 patients (55.2% female) with a mean age of 37.8±11.5 years and a median body mass index of 42.2 (30.2 to 74.2) kg/m2. The 241 patients in the first group underwent LSG without fixation, and the 476 patients in the second group with fixation. Functional stenosis was detected in 8 patients, all of whom were in group 1. One patient in group 1 had a leak on the background of functional stenosis. There was bleeding that required transfusion in 2 patients (group 1) and reoperation in 2 patients (group 2). None of the study patients died. During the in-hospital period, 122 (50.6%) patients in group 1 and 159 (33.4%) patients in group 2 had nausea and vomiting that required antiemetic treatment (P<0.001).
Gastric sleeve fixation in LSG prevents complications that may arise because of improper gastric mobilization. This method is effective in reducing nausea and vomiting in LSG patients.
本研究旨在确定胃袖套固定是否可预防功能性狭窄（扭曲或扭结），并探讨其对腹腔镜袖套胃切除术（LSG）后恶心和呕吐等症状的影响。
纳入 2012 年至 2019 年间接受初次 LSG 治疗病态肥胖且至少完成 1 年随访的 717 例患者。所有手术均由同一手术团队使用相同技术完成。将患者分为 2 组，即组 1：标准 LSG 组；组 2：LSG 加胃袖套固定组。比较两组患者的人口统计学特征、基线体质量指数、随访时间、出血、漏液、胃狭窄、术后恶心、呕吐和需要使用止吐药的情况。在随访期间，怀疑有胃狭窄的患者行内镜检查和上消化道造影。
717 例患者（55.2%为女性）接受了 LSG，平均年龄为 37.8±11.5 岁，中位体质量指数为 42.2（30.2 至 74.2）kg/m2。第 1 组 241 例患者未行胃袖套固定，第 2 组 476 例患者行胃袖套固定。8 例患者出现功能性狭窄，均为第 1 组患者。1 例功能性狭窄患者同时并发漏液。第 1 组有 2 例患者需要输血，2 例患者需要再次手术。研究患者均未死亡。住院期间，第 1 组 122（50.6%）例患者和第 2 组 159（33.4%）例患者出现需要使用止吐药治疗的恶心和呕吐（P<0.001）。
LSG 中胃袖套固定可预防因胃游离不当引起的并发症。该方法可有效减少 LSG 患者的恶心和呕吐。
