Department of Radiology, Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea.
Department of Surgery, Gil Medical Center, Gachon University Gil Hospital, Gachon University College of Medicine, 1198, Guwol-dong, Namdong-Gu, 405-760, Incheon, Republic of Korea.
Obes Surg. 2021 Jul;31(7):2878-2886. doi: 10.1007/s11695-021-05354-5. Epub 2021 Mar 23.
Laparoscopic sleeve gastrectomy (SG) is now frequently performed as a definitive bariatric procedure. The aim of the study was to evaluate the detailed morphology of remnant stomachs after SG with respect to volume and sleeve migration.
We performed a review of prospectively collected data on patients that completed a 12-month postop examination, which included CT volumetry of the sleeve, and a questionnaire that addressed postop food tolerance. CT volumetry study included total sleeve volume (TSV), tube volume (TV), antral volume (AV), tube/antral volume ratio (TAVR), and the presence of intrathoracic sleeve migration (ITSM).
One hundred patients were included in this study. Mean %TWL (total weight loss) at 12 months postop was 31.1% (14.3~55.5), and mean TSV, TV, AV, and TAVR were 188.3 ± 67.3 ml, 81.3 ± 38.5 ml. 107.0 ± 45.1 ml, and 0.846 ± 0.514 respectively. TSV was not correlated significantly with %TWL at 12 months postop (r=-0.140, p=0.164). Thirty patients (30/100, 30%) showed ITSM. Patients with ITSM had a significantly lower mean GER score (5.9 ± 2.3 vs. 7.5±1.9, p=0.001), and a higher proportion showed suboptimal weight loss (43.3% vs. 15.7%, p=0.003).
Mean TSV was not found to be significantly correlated with %TWL at 12 months postop. The presence of ITSM indicated more frequent GER symptoms and a higher probability of suboptimal weight loss.
腹腔镜袖状胃切除术（SG）现在经常作为一种确定性减重手术进行。本研究旨在评估 SG 后残胃的详细形态，包括胃袖管体积和迁移。
我们对完成 12 个月术后检查的患者进行了前瞻性数据回顾，包括胃袖管 CT 容积测量和一份评估术后食物耐受性的问卷。CT 容积研究包括总袖管容积（TSV）、管容积（TV）、胃窦容积（AV）、管/胃窦容积比（TAVR）以及胸内袖管迁移（ITSM）的存在。
本研究共纳入 100 例患者。术后 12 个月时的平均 %TWL（总体重减轻）为 31.1%（14.3~55.5），平均 TSV、TV、AV 和 TAVR 分别为 188.3±67.3ml、81.3±38.5ml、107.0±45.1ml 和 0.846±0.514。术后 12 个月时 TSV 与 %TWL 无显著相关性（r=-0.140，p=0.164）。30 例（30/100，30%）出现 ITSM。存在 ITSM 的患者 GER 评分明显较低（5.9±2.3 与 7.5±1.9，p=0.001），并且有更高比例的患者出现体重减轻不理想（43.3%与 15.7%，p=0.003）。
术后 12 个月时，平均 TSV 与 %TWL 无显著相关性。存在 ITSM 表明更频繁的 GER 症状和更高的体重减轻不理想的可能性。
