可调节垂直胃绑带术并不能消除吻合钉线破裂的风险。
An adjustable vertical banded gastroplasty does not eliminate the risk of staple-line disruption.
作者信息
Näslund E, Backman L, Granström L
机构信息
Division of Surgery, Karolinska Institute at Danderyd Hospital, Stockholm, Sweden.
出版信息
Obes Surg. 1998 Aug;8(4):434-6. doi: 10.1381/096089298765554322.
BACKGROUND
The two main reasons for reoperation after vertical banded gastroplasty (VBG) in the treatment of obesity are staple-line disruption and stomal stenosis.
PATIENTS
Seven morbidly obese patients of mean (+/-SEM) body mass index (BMI) 43.7 +/- 1.9 kg/m2 treated with an adjustable vertical banded gastroplasty (AVBG).
RESULTS
No complications of the band system were reported. Weight-loss [BMI at 2 years follow-up 33.9 +/- 6.9 kg/m2 (n = 5)] was equivalent to that seen after VBG with a fixed band. Two of the patients developed staple-line disruption at 18 and 24 months after surgery.
CONCLUSION
AVBG allows adjustment of the stoma, but staple-line disruption was common in this small series. It is possible that an excessive filling of the band in order to achieve excess weight loss results in a high pressure in the upper pouch which increases the risk of staple-line disruption.
背景
垂直绑扎胃成形术（VBG）治疗肥胖症后再次手术的两个主要原因是吻合钉线破裂和吻合口狭窄。
患者
7例病态肥胖患者，平均（±标准误）体重指数（BMI）为43.7±1.9kg/m²，接受了可调节垂直绑扎胃成形术（AVBG）治疗。
结果
未报告束带系统的并发症。体重减轻情况[2年随访时的BMI为33.9±6.9kg/m²（n = 5）]与使用固定束带的VBG术后情况相当。2例患者在术后18个月和24个月出现吻合钉线破裂。
结论
AVBG可调节吻合口，但在这个小系列研究中吻合钉线破裂很常见。为了实现过多的体重减轻而过度充盈束带可能会导致上袋内压力升高，从而增加吻合钉线破裂的风险。
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