Department of Surgery, St. Antonius Hospital, Nieuwegein, The Netherlands.
Department of Surgery, St. Antonius Hospital, Nieuwegein, The Netherlands.
Surg Obes Relat Dis. 2021 May;17(5):1017-1028. doi: 10.1016/j.soard.2021.01.006. Epub 2021 Jan 21.
Intussusception is a rare yet potentially life-threatening complication following Roux-en-Y gastric bypass (RYGB). Multiple case reports have described this complication, and recently, several retrospective studies have been published describing the surgical treatment of intussusception. The aim of this study was to determine the incidence of intussusception following RYGB and provide insight into outcomes of subsequent operative treatment. A systematic search was performed using the PubMed and Cochrane databases. Article selection was performed using the preferred reporting items for systematic reviews and meta-analyses criteria, and selecting articles describing the incidence of intussusception following RYGB. Data was pooled only when 3 or more comparable studies reported on the same outcome. The incidence of intussusception and outcomes of subsequent treatment were analyzed. Furthermore, all published case reports describing intussusception following RYGB were analyzed. A total of 74 studies published between 1991 and 2020 were included, describing 191 patients who underwent RYGB and developed intussusception. We retrieved 68 case reports, including 84 patients, and 6 retrospective studies describing outcomes of surgical treatment in 107 patients, which were used to pool data. There was a predominance of females among the included patients (85%-98%), and patients had significant weight loss following RYGB. The pooled incidence of intussusception following RYGB was .64%. Resection of the affected segment was performed in 34% of the patients. A pooled recurrence rate of 22% was found during follow-up. Resection and reconstruction of the jejunojejunostomy appears to be associated with the lowest risk of recurrence and acceptable complication rates. The pooled incidence of intussusception following RYGB is 0.64%. Typically, patients are female with significant weight loss after RYGB. Symptoms include abdominal pain, nausea, and vomiting. Diagnosis is based on clinical findings and computed tomography scans, warranting early surgical exploration due to the high risk for ischemia. Resection of the jejunojejunostomy appears to be associated with the lowest recurrence rates and acceptable complication rates.
肠套叠是 Roux-en-Y 胃旁路术（RYGB）后一种罕见但潜在危及生命的并发症。已有多篇病例报告描述了这种并发症，最近，也有几篇回顾性研究发表，描述了肠套叠的手术治疗。本研究旨在确定 RYGB 后肠套叠的发生率，并深入了解后续手术治疗的结果。使用 PubMed 和 Cochrane 数据库进行了系统搜索。使用系统评价和荟萃分析的首选报告项目标准进行文章选择，并选择描述 RYGB 后肠套叠发生率的文章。只有当 3 篇或更多具有可比性的研究报告了相同的结果时，才对数据进行汇总。分析了肠套叠的发生率和后续治疗的结果。此外，还分析了所有已发表的描述 RYGB 后肠套叠的病例报告。1991 年至 2020 年期间共纳入 74 项研究，描述了 191 例接受 RYGB 并发生肠套叠的患者。我们共检索到 68 篇病例报告，共 84 例患者，以及 6 篇回顾性研究，描述了 107 例患者手术治疗的结果，这些研究用于汇总数据。纳入患者中女性居多（85%-98%），且 RYGB 后体重明显减轻。RYGB 后肠套叠的总发生率为 0.64%。34%的患者进行了受累段的切除术。在随访中发现复发率为 22%。空肠空肠吻合口的切除和重建似乎与复发风险最低和可接受的并发症发生率相关。RYGB 后肠套叠的发生率为 0.64%。通常，患者为女性，RYGB 后体重明显减轻。症状包括腹痛、恶心和呕吐。诊断基于临床发现和计算机断层扫描，由于存在高缺血风险，因此需要早期手术探查。空肠空肠吻合口的切除似乎与最低的复发率和可接受的并发症发生率相关。
