Double Half Purse-String Sutures Plus "8" Pattern of Stitching for Prevention of Duodenal Stump Fistula after Laparoscopic Gastrectomy.

IF 1.1 4区 医学 Q3 SURGERY
Qiancheng Wang, Zeshen Wang, Shiyang Jin, Yuming Ju, Pengcheng Sun, Yuzhe Wei, Guanyu Zhu, Kuan Wang
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引用次数: 0

Abstract

Background: Duodenal stump fistula represents an infrequent but serious complication after laparoscopic radical gastrectomy with Billroth II or Roux-en-Y reconstruction for gastric cancer. The present study was designed to evaluate the effectiveness of laparoscopic double half purse-string sutures plus "8" pattern of stitching for reinforcement of duodenal stump. Methods: The data of patients undergoing laparoscopic radical gastrectomy with Billroth II or Roux-en-Y reconstruction were retrospectively analyzed between August 2022 and June 2023. According to the different reinforcement methods of duodenal stump, included patients were subdivided into three groups as follows: Group A, duodenal stump was treated with double half purse-string sutures plus "8" pattern of stitching; Group B, duodenal stump was reinforced by continuous suture using a barbed suture; and Group C, duodenal stump without any additional processing. The incidences of duodenal stump fistula between three groups were documented and compared. Moreover, the independent risk factors associated with duodenal stump fistula were analyzed using the logistic regression analysis. Results: No postoperative duodenal stump fistula occurred in Group A, which was significantly different from Group B and Group C (P = .007). In the multivariate analysis, age (odds ratio [OR], 1.191; 95% confidence interval [CI], 1.088-1.303), body mass index (OR, 0.824; 95% CI, 0.727-0.935), and American Society of Anesthesiologists score (OR, 4.495; 95% CI, 1.264-15.992) were the risk factors for duodenal stump fistula. Conclusion: Double half purse-string sutures plus "8" pattern of suture can be conducted in a relatively short operation period and could prevent the incidence of duodenal stump fistula to some extent.

腹腔镜胃切除术后预防十二指肠残端瘘的双半钱包线缝合加 "8 "字形缝合。
背景:十二指肠残端瘘是胃癌腹腔镜根治性胃切除术(Billroth II或Roux-en-Y重建术)后一种不常见但严重的并发症。本研究旨在评估腹腔镜双半荷包线缝合加 "8 "字缝合模式用于十二指肠残端加固的有效性。研究方法回顾性分析2022年8月至2023年6月期间接受腹腔镜根治性胃切除术并行比洛斯II或Roux-en-Y重建的患者数据。根据十二指肠残端加固方法的不同,将纳入的患者细分为以下三组:A组,十二指肠残端采用双半荷包线缝合加 "8 "字形缝合;B组,十二指肠残端采用倒钩线连续缝合加固;C组,十二指肠残端不做任何额外处理。记录并比较了三组十二指肠残端瘘的发病率。此外,还利用逻辑回归分析法分析了与十二指肠残端瘘相关的独立风险因素。结果A 组未发生术后十二指肠残端瘘,与 B 组和 C 组相比差异显著(P = .007)。在多变量分析中,年龄(比值比 [OR],1.191;95% 置信区间 [CI],1.088-1.303)、体重指数(OR,0.824;95% CI,0.727-0.935)和美国麻醉医师协会评分(OR,4.495;95% CI,1.264-15.992)是十二指肠残端瘘的风险因素。结论双半荷包线缝合加 "8 "字形缝合可在较短的手术时间内完成,并可在一定程度上预防十二指肠残端瘘的发生。
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来源期刊
CiteScore
2.90
自引率
0.00%
发文量
163
审稿时长
3 months
期刊介绍: Journal of Laparoendoscopic & Advanced Surgical Techniques (JLAST) is the leading international peer-reviewed journal for practicing surgeons who want to keep up with the latest thinking and advanced surgical technologies in laparoscopy, endoscopy, NOTES, and robotics. The Journal is ideally suited to surgeons who are early adopters of new technology and techniques. Recognizing that many new technologies and techniques have significant overlap with several surgical specialties, JLAST is the first journal to focus on these topics both in general and pediatric surgery, and includes other surgical subspecialties such as: urology, gynecologic surgery, thoracic surgery, and more.
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