Hocking M P, Kelly K A, Callaway C W
Mayo Clin Proc. 1986 Apr;61(4):287-91. doi: 10.1016/s0025-6196(12)61932-6.
Our objective was to develop an operation for morbid obesity that would be simple, safe, and effective and yet have few long-term adverse physiologic effects. Vertical gastroplasty was chosen. A small proximal gastric pouch was fashioned by stapling vertically beginning 5 cm distal to the cardia along the lesser curvature of the stomach and ending just lateral to the esophagogastric junction along the greater curvature. A 1.1-cm channel through the staple line was left near the lesser curvature of the stomach. No gastric incisions, enterostomies, or anastomoses were necessary. Among 57 patients (with a mean +/- SEM preoperative weight of 136 +/- 4.5 kg) operated on since January 1981, no deaths occurred and no gastric reoperations were done. The hospital stay was short (mean, 9 days). In 32 patients who were followed up for 1 year or longer, the mean percentage of excess weight lost was 39% at 6 months, 43% at 12 months, and 34% at 24 months. Two patients had disruption of the staple line and regained weight by 24 months postoperatively. Channel stenosis occurred within 6 months after operation in seven patients, all of whom were managed successfully with endoscopic dilation. We conclude that vertical gastroplasty is a simple, safe operation for morbid obesity with few adverse sequelae, but the percentage of excess weight lost during a 1- to 4-year follow-up exceeded 50% in only 31% of our patients.
我们的目标是开发一种用于治疗病态肥胖的手术，该手术应简单、安全且有效，同时长期不良生理影响较少。我们选择了垂直胃成形术。通过沿着胃小弯从贲门远侧5厘米处开始垂直缝合，直至沿着胃大弯在食管胃交界处外侧结束，形成一个小的近端胃囊。在胃小弯附近的钉合线处留一个1.1厘米的通道。无需进行胃切口、肠造口术或吻合术。自1981年1月以来接受手术的57例患者（术前平均体重±标准误为136±4.5千克）中，无死亡病例，也未进行胃再次手术。住院时间短（平均9天）。在32例随访1年或更长时间的患者中，6个月时超重减轻的平均百分比为39%，12个月时为43%，24个月时为34%。2例患者钉合线破裂，术后24个月体重恢复。7例患者术后6个月内发生通道狭窄，均通过内镜扩张成功处理。我们得出结论，垂直胃成形术是一种治疗病态肥胖的简单、安全的手术，不良后遗症较少，但在1至4年的随访期间，只有31%的患者超重减轻百分比超过50%。
