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腹腔镜胃袖状切除术后网膜减少对改善恶心呕吐和胃食管反流症状的研究。

A Study of Omentum Reduction on the Improvement of Nausea and vomiting and Gastroesophageal Reflux Symptoms After Laparoscopic Gastric Sleeve Resection.

机构信息

Department of Bariatric and Metabolic Diseases Surgery, Guangdong Provine, Xiaolan People's Hospital of Zhongshan, Jucheng Rd. Xiaolan Dist.528415, No. 65, Zhongshan, P.R. China.

Department of Maternal and Child Operating Room, Xiaolan People's Hospital of Zhongshan, Guangdong, China.

出版信息

Obes Surg. 2024 Sep;34(9):3390-3400. doi: 10.1007/s11695-024-07423-x. Epub 2024 Aug 5.

Abstract

OBJECTIVE

To investigate the effect of omentum reduction in laparoscopic sleeve gastrectomy (LSG) on the improvement of postoperative nausea and vomiting and gastroesophageal reflux symptoms.

METHODS

A retrospective study was performed on the case data of 198 obese patients who underwent LSG in the Department of Obesity and Metabolic Diseases of Xiaolan People's Hospital of Zhongshan from March 2021 to March 2022 and were divided into omentum reduction group and control group, with 99 cases in each group, and the preoperative body mass index (BMI) of the patients was recorded. Age, gender, comorbidities, and comparative analysis of operation time, blood loss, length of hospital stay, postoperative nausea and vomiting score, gastroesophageal reflux GerdQ score, postoperative pain score, weight, and postoperative complications were analyzed.

RESULTS

There were no significant differences in preoperative BMI, age, gender and comorbidities between the two groups (P > 0.05), but there were significant differences in intraoperative blood loss and operation time (P < 0.05). There were differences in postoperative nausea and vomiting scores and VAS pain scores between the two groups (P < 0.05). The GerdQ scores of the omental reduction group were 8.11 ± 2.84 points at 1 year, and those in the control group were 7.56 ± 2.67 points, which were 3.97 ± 4.09 points higher than those in the preoperative omentum reduction group and 3.42 ± 3.41 in the control group, with no significant difference (P > 0.05). There was no significant difference in the postoperative excess weight loss rate %EWL and postoperative complications (p > 0.05).

CONCLUSION

Omentum reduction can improve short-term nausea and vomiting after LSG, but it cannot significantly improve long-term reflux symptoms.

摘要

目的

探讨腹腔镜袖状胃切除术(LSG)中网膜减少对改善术后恶心呕吐和胃食管反流症状的影响。

方法

回顾性分析 2021 年 3 月至 2022 年 3 月在中山市小榄人民医院肥胖与代谢病科行 LSG 的 198 例肥胖患者的病例资料,分为网膜减少组和对照组,每组 99 例,记录患者术前体质量指数(BMI)。年龄、性别、合并症,比较分析手术时间、术中出血量、住院时间、术后恶心呕吐评分、胃食管反流 GerdQ 评分、术后疼痛评分、体重、术后并发症。

结果

两组患者术前 BMI、年龄、性别、合并症比较差异无统计学意义(P>0.05),但术中出血量和手术时间比较差异有统计学意义(P<0.05)。两组患者术后恶心呕吐评分和 VAS 疼痛评分比较差异有统计学意义(P<0.05)。网膜减少组患者术后 1 年的 GerdQ 评分分别为 8.11±2.84 分,对照组为 7.56±2.67 分,分别比术前网膜减少组高 3.97±4.09 分,比对照组高 3.42±3.41 分,差异无统计学意义(P>0.05)。术后体质量丢失率 %EWL 和术后并发症差异无统计学意义(p>0.05)。

结论

网膜减少可改善 LSG 术后短期恶心呕吐,但不能明显改善长期反流症状。

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