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全内脏转位患者的腹腔镜Roux-en-Y胃旁路手术:病例报告

Laparoscopic Roux-en-Y gastric bypass in a patient with situs inversus totalis: case report.

作者信息

Zorrilla-Blanco Pablo Gerardo, Muñoz-Maldonado Gerardo, Zorrilla-Nuñez Luis Fernando, Núñez-Jasso Noé, González-Zorrilla Fernando, Mata-De Anda Lilia Andrea, de la O-Escamilla Manuel

机构信息

Department of General Surgery, Hospital Universitario "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, México.

出版信息

J Surg Case Rep. 2022 Jul 22;2022(7):rjac336. doi: 10.1093/jscr/rjac336. eCollection 2022 Jul.

Abstract

The purpose of this report is to present the case of a patient with situs inversus totalis (SIT) who underwent laparoscopic gastric bypass and review of the literature. Situs inversus is a rare congenital abnormality that occurs in ~0.01% of the population and is characterized by transposition of the abdominal viscera1. When associated with dextrocardia, it is known as SIT. Electrocardiography reveals a reversal of the electrical waves of the heart and is the diagnostic measure of choice. Roux-en-Y laparoscopic gastric bypass for morbid obesity is one of the most effective bariatric procedures currently considered as the gold standard in bariatric surgery. We present the case of a 19-year-old male with morbid obesity and diagnosis of SIT, who underwent a laparoscopic gastric bypass adjusting the technique to the anatomical changes typical of this variant. It can be concluded, based on the previously compared cases and what was reported in ours, that in patients who have an indication to perform bariatric surgery and present SIT, surgery is not contraindicated, obtaining favorable results.

摘要

本报告旨在介绍一例患有完全性内脏反位(SIT)的患者接受腹腔镜胃旁路手术的病例,并对相关文献进行综述。内脏反位是一种罕见的先天性异常,发生率约为0.01%,其特征是腹部脏器的转位。当与右位心相关时,称为SIT。心电图显示心脏电波形反转,是首选的诊断方法。Roux-en-Y腹腔镜胃旁路手术治疗病态肥胖是目前最有效的减肥手术之一,被视为减肥手术的金标准。我们报告一例19岁患有病态肥胖且诊断为SIT的男性患者,他接受了腹腔镜胃旁路手术,并根据该变异的典型解剖变化调整了手术技术。根据之前比较的病例以及我们报告的内容可以得出结论,对于有减肥手术指征且患有SIT的患者,手术并非禁忌,可获得良好效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6f5a/9307269/204bc644e99e/rjac336f1.jpg

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