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腹腔镜袖状胃切除术中的网膜固定术:对减轻术后胃肠道症状是否有效。一项回顾性队列研究。

Omentopexy during laparoscopic sleeve gastrectomy: Is it effective in reducing postoperative gastrointestinal symptoms. A retrospective cohort study.

作者信息

AlHaddad Mohannad, AlAtwan Abrar A, AlKhadher Talal, AlJewaied Ali, Qadhi Iman, AlSabah Salman K

机构信息

Jaber Al Ahmad Al Sabah Hospital, South Surra, Kuwait.

Mubarak Al Kabeer Hospital, Jabriya, Hawalli, Kuwait.

出版信息

Ann Med Surg (Lond). 2021 Apr 30;65:102369. doi: 10.1016/j.amsu.2021.102369. eCollection 2021 May.

Abstract

BACKGROUND

Postoperative gastrointestinal symptoms are common in patients undergoing sleeve gastrectomy. This study is aimed to assess the effectiveness of omentopexy during laparoscopic sleeve gastrectomy in reducing gastrointestinal symptoms.

METHODS

A retrospective analysis of patients who underwent laparoscopic sleeve gastrectomy with and without omentopexy in the period between January 2016 to September 2017. All procedures were performed by three surgeons utilizing the same surgical technique. Data extracted included patient socio-demographics', preoperative body mass index (BMI), hospitalization period, treatments and post-operative gastrointestinal symptoms. It contained the GERD-Health Related Quality of Life Questionnaire (GERD-HRQL) measuring symptom severity in gastro esophageal reflux disease (GERD). Data were analyzed at 6, 12 and 18 months with reference to weight loss.

RESULTS

A total of 140 patients were included in this study, 70 in each group arm. Age, preoperative BMI, pre-operative co-morbid conditions like hypertension, diabetes, and asthma were considered as confounding variables among the two groups. None of the previous factors were statistically significantly different among both groups. The outcomes of both groups were compared in terms of postoperative nausea, vomiting, regurgitation, intra-hospital stay, medication use, early return to work, and EWL%. None of the previous outcomes except for days of hospital stay and ondansetron use was found to be significantly different between both groups.

CONCLUSION

Omentopexy does not change the outcome for laparoscopic sleeve gastrectomy in terms of gastrointestinal symptoms or weight loss results.

摘要

背景

袖状胃切除术后的胃肠道症状在接受该手术的患者中很常见。本研究旨在评估腹腔镜袖状胃切除术中网膜固定术在减轻胃肠道症状方面的有效性。

方法

对2016年1月至2017年9月期间接受或未接受网膜固定术的腹腔镜袖状胃切除术患者进行回顾性分析。所有手术均由三位外科医生采用相同的手术技术进行。提取的数据包括患者的社会人口统计学信息、术前体重指数(BMI)、住院时间、治疗情况及术后胃肠道症状。其中包含用于测量胃食管反流病(GERD)症状严重程度的GERD-健康相关生活质量问卷(GERD-HRQL)。参照体重减轻情况,在6个月、12个月和18个月时对数据进行分析。

结果

本研究共纳入140例患者,每组70例。年龄、术前BMI以及高血压、糖尿病和哮喘等术前合并症被视为两组间的混杂变量。两组在上述因素方面均无统计学显著差异。比较两组在术后恶心、呕吐、反流、住院时间、药物使用、早日恢复工作及体重减轻百分比等方面的结果。除住院天数和昂丹司琼使用情况外,两组在上述结果方面均未发现显著差异。

结论

就胃肠道症状或体重减轻结果而言,网膜固定术并未改变腹腔镜袖状胃切除术的疗效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c38b/8121878/b8cc41a70d6c/gr1.jpg

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