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网膜固定术对腹腔镜袖状胃切除术并发症的疗效。

Efficacy of Omentopexy on Complications of Laparoscopic Sleeve Gastrectomy.

机构信息

General Surgery Department, Bahcesehir University VM Medical Park Pendik Hospital, Fevzi Çakmak Mahallesi, D100, Cemal Gürsel Cd. No:9, Pendik, 34899, Istanbul, Turkey.

General Surgery Department, Dogus University VM Medical Park Pendik Hospital, Fevzi Çakmak Mahallesi, D100, Cemal Gürsel Cd. No:9, Pendik, 34899, Istanbul, Turkey.

出版信息

Obes Surg. 2024 Sep;34(9):3298-3305. doi: 10.1007/s11695-024-07363-6. Epub 2024 Jun 24.

Abstract

BACKGROUND

Laparoscopic sleeve gastrectomy (LSG) is a commonly performed type of bariatric surgery. Early complications of LSG include bleeding, leakage, pulmonary embolism, and surgical site infections. Most surgeons try to implement preventive methods, such as omentopexy. Staple line-imbrication, which has a difficult learning curve, often prevents complications. This study aimed to evaluate the effect of omentopexy on patients with imbricated LSG.

MATERIAL AND METHODS

The study applied a retrospective data analysis design to patients who underwent LSG between 2020 and 2023. All patients' staple lines were imbricated, and patients were then divided into two groups: omentopexy group and control group. Patients' demographic features, such as age, gender, height, weight, body mass index(BMI), bleeding, leakage, and reoperations, were recorded and examined retrospectively.

RESULTS

A total of 1356 patients were included in the study (540 in omentopexy, 816 in control), of which the mean age was 37.9 ± 10.5 years, 82.3% were women, and mean BMI was 40.9 ± 5.8 kg/m. The mean bleeding rate was 1.0% (1.3-0.7%), the mean leakage rate was 0.2% (0.2-0.2%, respectively), and the mean reoperation rate was 0.6% (0.7% and 0.5%, respectively). No statistically significant differences were observed.

CONCLUSION

Omentopexy is a technique that is widely used to prevent staple line complications. According to our study, omentopexy applied to an imbricated stapler line increased the operation time but did not affect bleeding or leakage ratios. This is the first study to evaluate the effect of omentopexy on imbricated staple lines. The findings of the study indicate that omentopexy has no additional benefit on early complications when using staple-line imbrication.

摘要

背景

腹腔镜袖状胃切除术(LSG)是一种常见的减重手术类型。LSG 的早期并发症包括出血、漏液、肺栓塞和手术部位感染。大多数外科医生都试图实施预防方法,如网膜固定术。钉线交织具有陡峭的学习曲线,常可预防并发症。本研究旨在评估网膜固定术对交织 LSGS 患者的影响。

材料与方法

本研究采用回顾性数据分析设计,纳入 2020 年至 2023 年间行 LSG 的患者。所有患者的吻合线均进行交织,然后将患者分为两组:网膜固定组和对照组。记录并回顾性检查患者的人口统计学特征,如年龄、性别、身高、体重、体重指数(BMI)、出血、漏液和再次手术。

结果

本研究共纳入 1356 例患者(网膜固定组 540 例,对照组 816 例),平均年龄为 37.9±10.5 岁,82.3%为女性,平均 BMI 为 40.9±5.8kg/m²。平均出血率为 1.0%(1.3%-0.7%),平均漏液率为 0.2%(0.2%-0.2%),平均再次手术率为 0.6%(0.7%和 0.5%)。两组间差异无统计学意义。

结论

网膜固定术是一种广泛用于预防吻合线并发症的技术。根据我们的研究,应用于交织吻合器线的网膜固定术增加了手术时间,但不影响出血或漏液率。这是第一项评估网膜固定术对交织吻合线影响的研究。该研究结果表明,在使用钉线交织时,网膜固定术对早期并发症没有额外益处。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bdea/11349786/7b9725daa1c0/11695_2024_7363_Fig1_HTML.jpg

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