Endo Yuichi, Orimoto Hiroki, Nakamura Shun, Miyoshino Wataru, Nagasawa Yuiko, Kawano Yoko, Takayama Hiroomi, Masuda Takashi, Hirashita Teijiro, Inomata Masafumi
Oita University, Ōita, Japan.
Obes Surg. 2025 Mar;35(3):946-951. doi: 10.1007/s11695-025-07735-6. Epub 2025 Feb 12.
Laparoscopic sleeve gastrectomy (LSG) has become a widely utilized surgical procedure for losing weight since its approval for insurance coverage in Japan in 2014. Its efficacy has been demonstrated by research, but data concerning gastric wall thickness following surgery remain unavailable. Hence, this study aimed to measure gastric wall thickness in resected, formalin-fixed specimens and explore the influence of obesity-related comorbidities on these measurements.
This prospective study included 53 patients undergoing bariatric surgery at Oita University Hospital. Full-layer thickness (FLT) and muscle-layer thickness (MLT) in the antrum, body, and fornix of resected gastric specimens were measured. Data on patient demographics, comorbidities, and surgical procedure were also collected and analyzed using JMP software. Furthermore, associations between gastric wall thickness and patient factors were assessed.
The mean FLT in the antrum, body, and fornix was 2.9, 2.6, and 2.3 mm, with corresponding MLT of 1.2, 1.0, and 0.9 mm, respectively. The antrum exhibited the thickest gastric wall, whereas the fornix was the thinnest. Diabetes mellitus (DM) was associated with decreased MLT in the fornix, and obstructive sleep apnea (OSA) affected both FLT and MLT in the antrum.
Comorbidities such as DM and OSA significantly influence gastric wall thickness, particularly in the antrum and fornix. Understanding these variations is critical for optimizing surgical techniques and selecting the right stapler in LSG.
自2014年在日本被批准纳入保险范围以来，腹腔镜袖状胃切除术（LSG）已成为一种广泛应用的减肥手术。其疗效已得到研究证实，但术后胃壁厚度的数据仍然缺乏。因此，本研究旨在测量切除的、经福尔马林固定的标本中的胃壁厚度，并探讨肥胖相关合并症对这些测量结果的影响。
这项前瞻性研究纳入了53名在大分大学医院接受减肥手术的患者。测量切除的胃标本的胃窦、胃体和胃穹窿的全层厚度（FLT）和肌层厚度（MLT）。还收集了患者的人口统计学、合并症和手术过程的数据，并使用JMP软件进行分析。此外，评估了胃壁厚度与患者因素之间的关联。
胃窦、胃体和胃穹窿的平均FLT分别为2.9、2.6和2.3毫米，相应的MLT分别为1.2、1.0和0.9毫米。胃窦的胃壁最厚，而胃穹窿最薄。糖尿病（DM）与胃穹窿的MLT降低有关，阻塞性睡眠呼吸暂停（OSA）影响胃窦的FLT和MLT。
DM和OSA等合并症显著影响胃壁厚度，尤其是在胃窦和胃穹窿。了解这些差异对于优化手术技术和在LSG中选择合适的吻合器至关重要。
