Teke Emre, Ergin Anıl, Güneş Yasin, Bulut Nuriye Esen, Fersahoğlu Mehmet Mahir
University of Health Sciences, Gaziantep City Hospital, Gaziantep, Turkey.
University of Health Sciences, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey.
Obes Surg. 2025 May;35(5):1718-1725. doi: 10.1007/s11695-025-07822-8. Epub 2025 Mar 27.
Laparoscopic sleeve gastrectomy (LSG) is a widely performed bariatric surgery; however, some patients experience inadequate weight loss or weight regain, requiring revisional bariatric surgery such as Roux-en-Y gastric bypass (RYGB). Omentopexy, a technical variation during LSG, may influence long-term outcomes and the complexity of subsequent surgeries. This study aims to evaluate the impact of omentopexy during LSG on perioperative outcomes and surgery duration in patients requiring revisional RYGB.
This retrospective cohort study analyzed 62 patients who underwent revisional RYGB following primary LSG between January 2015 and January 2024. Patients were divided into two groups based on whether omentopexy was performed during the initial LSG. The primary outcomes assessed were perioperative complications, intrathoracic gastric migration (IGM), and surgery duration during RYGB. Secondary outcomes included hospital stay length and 30-day readmission rates.
Of the 62 patients, 56 were female and 6 were male, with a mean age of 44.3 years. The mean body mass index (BMI) was 39.5 kg/m. The omentopexy group (O-LSG) exhibited a significantly lower rate of perioperative complications (7.6%) compared to the non-omentopexy group (NO-LSG) (25%, p < 0.05). Intrathoracic gastric migration was observed in 13.8% of NO-LSG patients, while no cases were found in the O-LSG group. Additionally, surgery duration was significantly shorter in the O-LSG group (p < 0.05). No significant difference was found between the groups regarding hospital stay length or 30-day readmission rates.
Omentopexy during primary LSG is associated with reduced perioperative complications, shorter surgery durations, and lower rates of intrathoracic gastric migration during revisional RYGB. These findings suggest that performing omentopexy during LSG may simplify revisional procedures and improve patient outcomes.
腹腔镜袖状胃切除术（LSG）是一种广泛开展的减肥手术；然而，一些患者体重减轻不足或体重反弹，需要进行诸如 Roux-en-Y 胃旁路术（RYGB）等减肥修正手术。网膜固定术是 LSG 过程中的一种技术变异，可能会影响长期疗效以及后续手术的复杂性。本研究旨在评估 LSG 期间进行网膜固定术对需要进行修正 RYGB 的患者围手术期结局和手术时长的影响。
这项回顾性队列研究分析了 2015 年 1 月至 2024 年 1 月期间在初次 LSG 后接受修正 RYGB 的 62 例患者。根据初次 LSG 期间是否进行网膜固定术将患者分为两组。评估的主要结局是围手术期并发症、胸腔内胃移位（IGM）以及 RYGB 期间的手术时长。次要结局包括住院时间和 30 天再入院率。
62 例患者中，56 例为女性，6 例为男性，平均年龄 44.3 岁。平均体重指数（BMI）为 39.5kg/m²。与未行网膜固定术组（NO-LSG）（25%）相比，网膜固定术组（O-LSG）围手术期并发症发生率显著更低（7.6%，p＜0.05）。NO-LSG 组 13.8%的患者出现胸腔内胃移位，而 O-LSG 组未发现此类病例。此外，O-LSG 组的手术时长显著更短（p＜0.05）。两组在住院时间或 30 天再入院率方面未发现显著差异。
初次 LSG 期间进行网膜固定术与围手术期并发症减少、手术时长缩短以及修正 RYGB 期间胸腔内胃移位发生率降低相关。这些发现表明，在 LSG 期间进行网膜固定术可能会简化修正手术并改善患者结局。
