Department of General Surgery, Nottingham University Hospitals, Faculty of Medicine, Cairo University, Cairo, Egypt.
Department of Diagnostic Radiology, Faculty of Medicine, Cairo University, Cairo, Egypt.
J Laparoendosc Adv Surg Tech A. 2022 Sep;32(9):962-968. doi: 10.1089/lap.2021.0770. Epub 2022 Mar 3.
Laparoscopic sleeve gastrectomy is one of the most common bariatric procedures due its high success and low complication rates. However, acid reflux and food intolerance remain drawbacks of the procedure, with high frequency of postoperative gastroesophageal reflux disease (GERD) and eating disorders reported by previous studies. Omentopexy is not a standard technique in laparoscopic sleeve gastrectomy and showed promising results in preventing these sequelae. The present study aimed to evaluate whether omentopexy would decrease the incidence of postoperative GERD, food intolerance, and gastric volvulus without increasing additional complications rates in comparison with laparoscopic sleeve gastrectomy (LSG) without omentopexy. Our study included all the patients undergoing laparoscopic sleeve gastrectomy in our bariatric unit, who were divided into two groups. Group II had the added step of omentopexy. Comparison between both groups was done regarding incidence of acid reflux, food tolerance, and postoperative complications. Omentopexy decreased the incidence of acid reflux, gastric kink, volvulus, and intrathoracic migration. Moreover, food tolerance significantly improved in patients, which in turn led to higher compliance with the postoperative dietary plan and better outcome with regard to weight loss. In addition, omentopexy showed lower incidence of postoperative leakage. Omentopexy is a valuable step in laparoscopic sleeve gastrectomy, which should be considered a standard step in all cases.
腹腔镜袖状胃切除术因其高成功率和低并发症发生率，成为最常见的减肥手术之一。然而，酸反流和食物不耐受仍然是该手术的缺点，既往研究报道术后胃食管反流病（GERD）和饮食失调的发生率较高。网膜固定术不是腹腔镜袖状胃切除术的标准技术，但在预防这些后遗症方面显示出良好的效果。本研究旨在评估与未行网膜固定术的腹腔镜袖状胃切除术（LSG）相比，网膜固定术是否会降低术后 GERD、食物不耐受和胃扭转的发生率，而不会增加额外的并发症发生率。我们的研究包括在我们的减肥单位接受腹腔镜袖状胃切除术的所有患者，他们被分为两组。第 II 组增加了网膜固定术这一步骤。比较两组之间的酸反流、食物耐受性和术后并发症的发生率。网膜固定术降低了酸反流、胃扭结、扭转和胸腔内迁移的发生率。此外，患者的食物耐受性明显改善，这反过来又提高了对术后饮食计划的依从性，从而在减肥方面取得更好的效果。此外，网膜固定术术后漏的发生率较低。网膜固定术是腹腔镜袖状胃切除术的一个有价值的步骤，应被视为所有病例的标准步骤。
