Abosayed Amir K, Mostafa Mohamed Saber
Department of General Surgery, Kasr Alainy Hospital, Faculty of Medicine, Cairo University, ELmanial, Cairo, Egypt.
Obes Surg. 2022 Jun;32(6):1864-1871. doi: 10.1007/s11695-022-05995-0. Epub 2022 Mar 23.
Laparoscopic sleeve gastrectomy (LSG) has gained acceptance worldwide. However, SG has its own complications that need a specialized management. Omentopexy is a technique in which the sleeved part of the stomach is fixed to the greater omentum.
The present work aimed to investigate the potential effect of omentopexy on the upper GIT disturbances in patients with severe obesity and undergoing LSG.
This study included patients who were recruited for LSG in our institution from June 2019 to October 2020. Patients having no upper GIT symptoms, no esophagogastroduodenoscopy (EGD) GERD signs, and no hiatus hernia were eligible for the study. Patients were randomly enrolled into the omentopexy group (underwent LSG with omentopexy) and the non-omentopexy group (underwent LSG only). Patients were followed up 1 month, 3 months, and 1 year after the operation. EGD was performed at the 1-year follow-up.
Forty-five patients constituted the omentopexy group and forty-six constituted the non-omentopexy group. Omentopexy was associated with significant reduction in the early post LSG upper GIT symptoms, and less EGD evident reflux esophagitis at the 1-year follow-up (statistically non-significant).
The current work adds a new evidence of the omentopexy benefits in patients undergoing sleeve gastrostomy, with an overall better outcome in regard to the upper GIT upset and GERD compared to LSG alone.
腹腔镜袖状胃切除术（LSG）已在全球范围内得到认可。然而，袖状胃切除术有其自身的并发症，需要专门的管理。网膜固定术是一种将胃的袖状部分固定到大网膜的技术。
本研究旨在探讨网膜固定术对重度肥胖且接受LSG患者上消化道紊乱的潜在影响。
本研究纳入了2019年6月至2020年10月在我院接受LSG的患者。无上消化道症状、无食管胃十二指肠镜检查（EGD）显示的胃食管反流病（GERD）体征且无食管裂孔疝的患者符合研究条件。患者被随机分为网膜固定术组（接受带网膜固定术的LSG）和非网膜固定术组（仅接受LSG）。术后1个月、3个月和1年对患者进行随访。在1年随访时进行EGD检查。
网膜固定术组有45例患者，非网膜固定术组有46例患者。网膜固定术与LSG术后早期上消化道症状显著减少相关，且在1年随访时EGD显示的反流性食管炎较少（统计学上无显著差异）。
目前的研究为网膜固定术对接受袖状胃造口术患者的益处提供了新的证据，与单纯LSG相比，在改善上消化道不适和GERD方面总体效果更好。
