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单吻合口胃旁路术(OAGB)后吻合口漏的非手术治疗策略:文献综述

Nonoperative Management Strategies for Anastomotic Leaks After One Anastomosis Gastric Bypass (OAGB): A Literature Review.

作者信息

Farah Amir, Malshy Kamil, Tatakis Anna, Abboud Wisam, Mari Amir, Sayida Sa'd

机构信息

General Surgery, Medical College of Wisconsin, Milwaukee, USA.

Urology, University of Rochester Medical Center, Rochester, USA.

出版信息

Cureus. 2024 Sep 19;16(9):e69708. doi: 10.7759/cureus.69708. eCollection 2024 Sep.

Abstract

One Anastomosis Gastric Bypass (OAGB) has gained widespread acceptance as an effective bariatric surgery due to its relative simplicity and favorable outcomes in weight loss and metabolic improvement. However, anastomotic leaks, though uncommon, present a significant complication with the potential for severe morbidity and mortality if not managed appropriately. This review examines the range of nonoperative strategies currently employed to manage anastomotic leaks and fistulae following OAGB. The focus is on endoscopic techniques, including the use of clips, stents, suturing systems, internal drainage, vacuum therapy, and tissue sealants, which have been successfully used in various gastrointestinal surgeries. Although a proportion of patients will require surgical treatments, these strategies offer less invasive alternatives to surgical intervention and can be tailored to the specific characteristics of the leak and patient condition. However, the application of these techniques specifically for OAGB-related leaks is not as well-documented. This review lists the available evidence on these nonoperative approaches, highlighting some of their potential benefits and limitations. While these methods show promise, there is a clear need for further research to establish standardized protocols and optimize their use in the context of OAGB-related leaks and fistulae.

摘要

单吻合口胃旁路术(OAGB)因其相对简单,在减重和改善代谢方面效果良好,已作为一种有效的减肥手术而被广泛接受。然而,吻合口漏虽不常见,但却是一种严重并发症,如果处理不当,可能导致严重的发病率和死亡率。本综述探讨了目前用于处理OAGB术后吻合口漏和瘘的一系列非手术策略。重点是内镜技术,包括使用夹子、支架、缝合系统、内引流、负压治疗和组织密封剂,这些技术已在各种胃肠手术中成功应用。虽然一部分患者需要手术治疗,但这些策略提供了侵入性较小的手术干预替代方案,并且可以根据漏口的具体特征和患者情况进行调整。然而,这些技术专门用于OAGB相关漏口的应用记录并不充分。本综述列出了关于这些非手术方法的现有证据,强调了它们的一些潜在益处和局限性。虽然这些方法显示出前景,但显然需要进一步研究以建立标准化方案,并在OAGB相关漏口和瘘的情况下优化其使用。

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