Martin M B, Kon N D, Meredith J H
Am Surg. 1985 Apr;51(4):197-200.
This retrospective study analyzes the results of 198 consecutive greater curvature gastroplasties performed in 23 male and 175 female patients with morbid obesity. The gastroplasty consisted of the creation of a 30-50 cm3 proximal gastric pouch by a double application of the TA-90 stapler, modified by removing three staples near the pin and trimming the cartridge to prevent crushing of the stomach at the outlet. The outlet was calibrated to a diameter of 1 cm and reinforced with a polypropylene seromuscular suture. No deaths occurred; postoperative complications included 32 superficial wound infections (16.2%), 24 incisional hernias (12.0%), 15 staple-line disruptions (7.6%), seven gastric outlet obstructions (3.5%), five subphrenic abscesses (2.5%), three perforations (1.5%), one splenic infarction, and one enterocutaneous fistula. One hundred sixty-one (81%) patients have been followed for a mean of 34 months (range 24 to 56 months); their mean weight loss is 36.4 per cent +/- 32.9 per cent of excess body weight. Only 45.5 per cent of these patients can be considered to have had satisfactory weight loss. Because this is not as effective as other forms of surgical therapy, the authors do not recommend greater curvature gastroplasty for the treatment of morbid obesity.
这项回顾性研究分析了连续对23例男性和175例女性病态肥胖患者实施的198例大弯胃成形术的结果。胃成形术包括用TA - 90吻合器双重应用创建一个30 - 50立方厘米的近端胃囊，通过移除靠近钉的三个钉并修剪钉仓进行改良，以防止胃在出口处受压。出口校准为直径1厘米，并用聚丙烯浆肌层缝线加固。无死亡病例；术后并发症包括32例表浅伤口感染（16.2%）、24例切口疝（12.0%）、15例吻合线断裂（7.6%）、7例胃出口梗阻（3.5%）、5例膈下脓肿（2.5%）、3例穿孔（1.5%）、1例脾梗死和1例肠皮肤瘘。161例（81%）患者接受了平均34个月（范围24至56个月）的随访；他们的平均体重减轻为超重体重的36.4%±32.9%。这些患者中只有45.5%可被认为体重减轻效果满意。由于这种方法不如其他形式的手术治疗有效，作者不推荐大弯胃成形术用于治疗病态肥胖。
