小肠切除对胃旁路术后吻合口狭窄和边缘溃疡发生率的影响。
The impact of small bowel resection on the incidence of stomal stenosis and marginal ulcer after gastric bypass.
作者信息
Spaulding L
机构信息
Department of Surgery, University of Vermont College of Medicine, South Burlington 05403, USA.
出版信息
Obes Surg. 1997 Dec;7(6):485-7; discussion 488. doi: 10.1381/096089297765555214.
BACKGROUND
Stomal stenosis (SS) and marginal ulcer (MU) are reported to occur in 9-20% and 2-13%, respectively, of patients undergoing gastric bypass for morbid obesity. It is hypothesized that decreasing tension on the gastrojejunostomy by performing limited small bowel resection (SBR) would decrease ischemia, thereby decreasing the likelihood of SS and MU.
METHODS
A retrospective review of 150 consecutive gastric bypass patients operated by one surgeon from 1993 to 1996 was performed. The incidence of SS and MU was compared in patients with and without SBR.
RESULTS
The overall rate of SS was 24.0% and that of MU was 9.3%: the incidence of both was 2.0%. The incidence of SS in patients without SBR was 26.9% and with SBR was 19.6%. The incidence of MU in patients without SBR was 8.9% and with SBR was 9.8%. Neither result was statistically significant by Fisher's exact test.
CONCLUSION
There is a trend towards a decrease in the incidence of SS in gastric bypass patients with concomitant SBR although this did not reach clinical significance.
背景
据报道，在接受胃旁路手术治疗病态肥胖的患者中，吻合口狭窄（SS）和边缘溃疡（MU）的发生率分别为9%至20%和2%至13%。据推测，通过进行有限的小肠切除术（SBR）降低胃空肠吻合术的张力会减少局部缺血，从而降低发生SS和MU的可能性。
方法
对1993年至1996年由一名外科医生连续实施手术的150例胃旁路手术患者进行回顾性研究。比较了有和没有进行SBR的患者中SS和MU的发生率。
结果
SS的总体发生率为24.0%，MU的总体发生率为9.3%，两者并发的发生率为2.0%。未进行SBR的患者中SS的发生率为26.9%，进行SBR的患者中为19.6%。未进行SBR的患者中MU的发生率为8.9%，进行SBR的患者中为9.8%。经Fisher精确检验，两个结果均无统计学意义。
结论
在同时进行SBR的胃旁路手术患者中，SS的发生率有下降趋势，尽管未达到临床显著性。
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