Gomez C A
Int J Obes. 1981;5(4):413-20.
Three hundred patients underwent gastroplasty surgery for morbid obesity. The operation consisted of formation of a 45 to 60 millilitre (ml) proximal gastric pouch with a 10 to 12 millimeter (mm) channel located on the greater curvature of the stomach. The channel was supported by a continued seromuscular inverting layer of 2-0 polypropylene and a second interrupted inverting layer of 4-0 Dacron sutures. The early postoperative complication rate was 18.7 percent, including one cardiac death, for a 0.33 percent mortality rate. Late postoperative complication rate was 27.0 percent, with vomiting heading the list. Staple-line disruption continued to be of concern with stapling in continuity. Liquid or pureed diet restriction for the first 12 postoperative weeks decreased the incidence of vomiting which contributed to early staple-line dehiscence. Two applications of the TA 90 and preservation of adequate blood supply to the pouch were important factors in the prevention of this complication. The department of clinical nutrition was directly involved in the preoperative classes in nutrition designed to assist patients in making the proper psychological adaptation to the newly imposed dietary restrictions. Over 90 percent of total weight loss occurred at 12 months. At 24 months there was a 32.5 percent decrease from preoperative weight and a 63.4 percent excess weight loss.
三百名病态肥胖患者接受了胃成形术。手术包括在胃大弯处形成一个45至60毫升的近端胃囊，并带有一个10至12毫米的通道。该通道由一层连续的2-0聚丙烯浆肌层翻转层和一层间断的4-0涤纶缝线翻转层支撑。术后早期并发症发生率为18.7%，包括1例心源性死亡，死亡率为0.33%。术后晚期并发症发生率为27.0%，呕吐位居首位。连续缝合时钉合线破裂仍是一个令人担忧的问题。术后前12周限制流食或泥状食物可降低呕吐发生率，呕吐是导致早期钉合线裂开的原因之一。使用两次TA 90以及保持胃囊充足的血供是预防该并发症的重要因素。临床营养科直接参与了术前营养课程，旨在帮助患者对新实施的饮食限制进行适当的心理调适。超过90%的体重减轻发生在12个月时。24个月时，体重比术前下降了32.5%，超重减轻了63.4%。
