Akhavan Moghaddam Jamal, Gholizadeh Hamed, Raei Mehdi, Khajat Fateme
Department of Surgery, Trauma Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.
Department of Epidemiology and Biostatistics, Faculty of Health, Baqiyatallah University of Medical Sciences, Tehran, Iran.
Obes Surg. 2025 Mar;35(3):1018-1025. doi: 10.1007/s11695-025-07695-x. Epub 2025 Jan 30.
Among bariatric surgeries, laparoscopic sleeve gastrostomy (LSG) has gained good global acceptance, but this surgery, like any other invasive procedure, has side effects. Various techniques have been tested to reduce these complications, which are used under the title of stapler line reinforcement (SLR). The purpose of this research is to compare the bleeding, leakage, mortality, food intolerance, re-hospitalization, and post-operative invasive therapeutic interventions in LSG surgery in two groups with and without omentopexy method.
In this retrospective cohort study, the patients who underwent LSG were included in the study and were compared in two groups with omentopexy and without omentopexy in terms of complications. The patients were followed up during the first year after the operation, and the patients were examined in terms of complications, including bleeding, leakage, mortality, food intolerance, re-hospitalization, and post-operative invasive therapeutic interventions.
In terms of bleeding (p = 0.263) and the frequency of leak cases (p = 0.286), no significant difference was observed between the two groups, but the treatment measures performed to control the leak had a significant difference between the two groups (p = 0.013). The need for re-admission was significantly higher (p = 0.017) in the group without omentopexy, and the need for re-surgery was also significantly different (p = 0.001) between the two groups. The frequency of food intolerance was significantly higher (p = 0.001) in the group without omentopexy, and the frequency of mortality was no statistically significant difference with the group with omentopexy (p = 0.304).
The results of this study showed that the need for more aggressive interventions (laparotomy) to control bleeding and leak is less in the group with omentopexy, also the chance of re-hospitalization and re-surgery after omentopexy is reduced, and food intolerance disorder is less in this group. Therefore, the findings of this study show that LSG with omentopexy has fewer side effects than without omentopexy.
在减肥手术中，腹腔镜袖状胃切除术（LSG）已获得全球广泛认可，但与其他任何侵入性手术一样，该手术也有副作用。人们已经测试了各种技术来减少这些并发症，这些技术统称为吻合器线加固（SLR）。本研究的目的是比较采用和不采用网膜固定术的两组LSG手术患者的出血、渗漏、死亡率、食物不耐受、再次住院以及术后侵入性治疗干预情况。
在这项回顾性队列研究中，纳入接受LSG手术的患者，并在并发症方面对采用网膜固定术和未采用网膜固定术的两组患者进行比较。在术后第一年对患者进行随访，并检查患者的并发症情况，包括出血、渗漏、死亡率、食物不耐受、再次住院以及术后侵入性治疗干预。
在出血方面（p = 0.263）和渗漏病例频率方面（p = 0.286），两组之间未观察到显著差异，但两组在控制渗漏所采取的治疗措施方面存在显著差异（p = 0.013）。未采用网膜固定术的组再次入院的需求显著更高（p = 0.017），两组之间再次手术的需求也存在显著差异（p = 0.001）。未采用网膜固定术的组食物不耐受的频率显著更高（p = 0.001），死亡率与采用网膜固定术的组无统计学显著差异（p = 0.304）。
本研究结果表明，采用网膜固定术的组控制出血和渗漏所需的更积极干预措施（剖腹手术）较少，网膜固定术后再次住院和再次手术的几率也降低，且该组食物不耐受障碍较少。因此，本研究结果表明，采用网膜固定术的LSG比未采用网膜固定术的副作用更少。
