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带网膜固定术的腹腔镜袖状胃切除术:它真的是一种有前景的方法吗?——一项Meta分析的系统评价

Laparoscopic Sleeve Gastrectomy with Omentopexy: Is It Really a Promising Method?-A Systematic Review with Meta-analysis.

作者信息

Zarzycki Piotr, Kulawik Jan, Małczak Piotr, Rubinkiewicz Mateusz, Wierdak Mateusz, Major Piotr

机构信息

2nd Department of General Surgery, Jagiellonian University Medical College, Jakubowskiego 2 st., 30-688, Krakow, Poland.

出版信息

Obes Surg. 2021 Jun;31(6):2709-2716. doi: 10.1007/s11695-021-05327-8. Epub 2021 Mar 6.

Abstract

PURPOSE

Laparoscopic sleeve gastrectomy (LSG) is one of the most commonly performed bariatric procedure worldwide. Omentopexy during LSG is a novel variation of this well-established technique. There are no clear conclusions on indications for this procedure, safeness, and effects of such a method. We aimed to compare the outcomes of laparoscopic sleeve gastrectomy (LSG) with omentopexy (OP) and without omentopexy.

MATERIALS AND METHODS

We searched the Medline, EMBASE, and Scopus databases up-to June 2020. Full-text articles and conference abstracts were included for further analysis. This review follows the PRISMA guidelines.

RESULTS

Of initial 66 records, only 4 studies (N = 1396 patients) were included in the meta-analysis. Our findings showed that LSG with omentopexy had significantly lowered overall morbidity compared to LSG without omentopexy (RR = 0.38; 95% CI [0.15, 0.94]; p=0.04). Gastric leakage rate (RR = 0.17; 95% CI [0.04, 0.76]; p = 0.02) was also significantly lower in LSG with omentopexy. There were no significant differences between groups in length of hospital stay.

CONCLUSIONS

Our meta-analysis showed that LSG with omentopexy may be a feasible procedure for decreasing morbidity and gastric leak rate. However, despite promising results, the procedure needs to be researched more in randomized controlled studies to draw solid conclusions.

摘要

目的

腹腔镜袖状胃切除术(LSG)是全球最常施行的减肥手术之一。LSG术中大网膜固定术是这一成熟技术的一种新变体。对于该手术的适应症、安全性及此方法的效果尚无明确结论。我们旨在比较有大网膜固定术(OP)和无大网膜固定术的腹腔镜袖状胃切除术(LSG)的手术效果。

材料与方法

我们检索了截至2020年6月的Medline、EMBASE和Scopus数据库。纳入全文文章和会议摘要以进行进一步分析。本综述遵循PRISMA指南。

结果

在最初的66条记录中,只有4项研究(N = 1396例患者)被纳入荟萃分析。我们的研究结果表明,与无大网膜固定术的LSG相比,有大网膜固定术的LSG总体发病率显著降低(RR = 0.38;95%CI [0.15, 0.94];p = 0.04)。有大网膜固定术的LSG胃漏率(RR = 0.17;95%CI [0.04, 0.76];p = 0.02)也显著更低。两组之间住院时间无显著差异。

结论

我们的荟萃分析表明,有大网膜固定术的LSG可能是一种降低发病率和胃漏率的可行手术。然而,尽管结果令人鼓舞,但该手术仍需在随机对照研究中进行更多研究以得出确凿结论。

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