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采用内镜下真空辅助闭合术治疗减重手术后的继发性瘘管

Management of secondary fistulas following bariatric surgery using endoscopic vacuum-assisted closure.

作者信息

Michel Macareno Alberto, Cobos Román Johanna Betzabe, De La Rosa Villa Niurky, Medina Estrada Ariana, Esparza Estrada Isaac

机构信息

Obesity Not 4 Me, Department of Bariatric and Metabolic Surgery, Río Médica, Leona Vicario 1451, 3er. Piso, Zona Urbana Rio Tijuana 22010 Tijuana, B.C., México.

出版信息

J Surg Case Rep. 2025 Mar 28;2025(4):rjaf176. doi: 10.1093/jscr/rjaf176. eCollection 2025 Apr.

DOI:10.1093/jscr/rjaf176
PMID:40161880
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11954368/
Abstract

Obesity significantly impacts individuals' quality of life. Bariatric surgery, including vertical sleeve gastrectomy and gastric bypass, is effective for long-term weight loss but has increased post-bariatric complications like fistulas. We treated three patients with post-bariatric complications. Cases included a gastropleural fistula secondary to vertical sleeve gastrectomy and an esophagojejunal fistula secondary to Roux-en-Y gastric bypass. Endoscopic vacuum-assisted closure (EVAC) was used, applying continuous negative pressure via a polyurethane sponge connected to suction. The EVAC technique effectively managed complex post-bariatric fistulas, facilitating closure and improving outcomes. Patient selection and technical expertise are crucial for optimizing EVAC results. This innovative approach offers a promising solution for post-bariatric complications, enhancing recovery and quality of life.

摘要

肥胖显著影响个人生活质量。减肥手术，包括垂直袖状胃切除术和胃旁路手术，对长期减重有效，但会增加减肥后并发症，如瘘管。我们治疗了三名减肥后并发症患者。病例包括垂直袖状胃切除术后继发的胃胸膜瘘和Roux-en-Y胃旁路术后继发的食管空肠瘘。采用了内镜下真空辅助闭合术（EVAC），通过连接吸引装置的聚氨酯海绵施加持续负压。EVAC技术有效处理了复杂的减肥后瘘管，促进了闭合并改善了治疗效果。患者选择和技术专长对于优化EVAC结果至关重要。这种创新方法为减肥后并发症提供了一个有前景的解决方案，可促进康复并提高生活质量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3f69/11954368/15bbf3955caf/rjaf176f8.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3f69/11954368/13b447ae60cc/rjaf176f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3f69/11954368/c2ace419a763/rjaf176f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3f69/11954368/b3543584acf5/rjaf176f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3f69/11954368/c57dd0850ed4/rjaf176f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3f69/11954368/08d22530528a/rjaf176f5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3f69/11954368/3fa12fcccf73/rjaf176f6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3f69/11954368/8aadde4f70a4/rjaf176f7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3f69/11954368/15bbf3955caf/rjaf176f8.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3f69/11954368/13b447ae60cc/rjaf176f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3f69/11954368/c2ace419a763/rjaf176f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3f69/11954368/b3543584acf5/rjaf176f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3f69/11954368/c57dd0850ed4/rjaf176f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3f69/11954368/08d22530528a/rjaf176f5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3f69/11954368/3fa12fcccf73/rjaf176f6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3f69/11954368/8aadde4f70a4/rjaf176f7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3f69/11954368/15bbf3955caf/rjaf176f8.jpg

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本文引用的文献

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