Second Department of Surgery, University of Medicine, Pharmacy, Science and Technology "George Emil Palade" of Târgu Mures, County Emergency Clinical Hospital of Târgu Mureş, 540109, Târgu Mureș, Romania.
University of Medicine, Pharmacy, Science and Technology "George Emil Palade" of Târgu Mures, Anaesthesiology and Intensive Care Clinic, County Emergency Clinical Hospital of Târgu Mureş, 540109, Târgu Mureș, Romania.
Obes Surg. 2023 Aug;33(8):2420-2427. doi: 10.1007/s11695-023-06681-5. Epub 2023 Jun 23.
Laparoscopic sleeve gastrectomy (LSG) is the most popular primary bariatric metabolic procedure worldwide but severe complications are still reported, and there is no ideal technique to avoid them. This study analyses the impact of oversewing (OS) and gastropexy (GP) on complication rate, early dyspeptic and late de novo GERD symptoms after LSG.
A case-control study was conducted on patients with obesity who underwent LSG. The total cohort was divided in group A (control group) - patients with no oversewing (OS) or gastropexy (GP), group B - patients with OS but no gastropexy and group C - patients with both OS and GP performed during LSG.
We included 272 patients with obesity with a mean BMI 42.9±6.94 kg/m, 96 patients in group A, 90 patients in group B and 86 in group C with no statistical differences between them. We had 5 cases of postoperative hemorrhage (4 in group A) and three patients who developed leaks (2 in group A and one in group B). Prolonged and severe early dyspeptic episodes and after 6 months reflux symptoms were significantly more in groups A and B (p<0.05). The operative time was longer in group B and C (p<0.05) but with no difference in procedure -related morbidity and in hospital length of stay.
Adding both OS and GP to LSG reduce complications rate with no influence on procedure-related postoperative morbidity and in-hospital length of stay. GP reduces early postoperative dyspeptic and de novo GERD symptoms after LSG.
腹腔镜袖状胃切除术（LSG）是目前全球应用最广泛的原发性减重代谢手术，但仍有严重并发症报告，且目前尚无理想的技术可以避免这些并发症。本研究分析了缝合加固（OS）和胃固定术（GP）对 LSG 后并发症发生率、早期消化不良和新发性胃食管反流病（GERD）症状的影响。
对接受 LSG 的肥胖患者进行病例对照研究。将总队列分为 A 组（对照组）-无缝合加固（OS）或胃固定术（GP）的患者、B 组-仅行 OS 但不行 GP 的患者和 C 组-行 OS 和 GP 的患者。
我们纳入了 272 例肥胖患者，平均 BMI 为 42.9±6.94kg/m，其中 A 组 96 例、B 组 90 例、C 组 86 例，组间无统计学差异。我们有 5 例术后出血（A 组 4 例）和 3 例发生漏诊（A 组 2 例和 B 组 1 例）。A 组和 B 组术后早期严重消化不良和 6 个月后反流症状显著更多（p<0.05）。B 组和 C 组手术时间较长（p<0.05），但手术相关发病率和住院时间无差异。
LSG 中同时行 OS 和 GP 可降低并发症发生率，对手术相关术后发病率和住院时间无影响。GP 可减少 LSG 后早期术后消化不良和新发性 GERD 症状。
