Magnetic single-anastomosis side-to-side duodeno-ileostomy for revision of sleeve gastrectomy in adults with severe obesity: 1-year outcomes.

IF 2.3 3区 医学 Q2 SURGERY
World Journal of Surgery Pub Date : 2024-10-01 Epub Date: 2024-08-01 DOI:10.1002/wjs.12304
Michel Gagner, Lamees Almutlaq, Gismonde Gnanhoue, J N Buchwald
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引用次数: 0

Abstract

Introduction: Uncomplicated surgical approaches that minimize anastomotic complications while improving revisional metabolic/bariatric surgical (MBS) outcomes are needed.

Methods: This prospective single-center study assessed the feasibility, safety, and efficacy of the novel linear magnetic anastomosis system (LMAS [3 cm]) in performing a side-to-side duodeno-ileostomy (MagDI) bipartition to revise clinically suboptimal primary sleeve gastrectomy (SG). Patients with severe obesity with/without type 2 diabetes (T2D) with suboptimal weight loss, regain, and/or T2D recurrence post SG underwent revisional MagDI. A distal and proximal magnet were delivered endoscopically to the ileum and duodenum and aligned via laparoscopic assistance. Gradual magnet fusion formed a DI bipartition.

Primary endpoints: technical feasibility, safety (Clavien-Dindo [CD] severe adverse event classification) at 1 year. Secondary endpoints: MBS weight and T2D reduction.

Results: July 29, 2022-March 28, 2023, 24 patients (95.8% female, mean age 44.9 ± 1.5 years, and body mass index [BMI] 39.4 ± 1.3 kg/m2) underwent MagDI. Feasibility was attained via correct magnet placement (mean operative time 63.5 ± 3.3 min), patent anastomoses created, and magnet passage per anus in 100.0% of patients. There were 4 CD-III mild or moderate severe AEs, 0.0% associated with the LMAS or MagDI: 0.0% anastomotic leakage, obstruction, bleeding, infection, reintervention, or death. Mean BMI reduction was 2.1 kg/m2 (p < 0.05); total weight loss 5.3%, excess weight loss 16.4%; and the patient with T2D improved.

Conclusion: The single-anastomosis MagDI procedure using the novel 3-cm LMAS to revise clinically suboptimal SG was technically straightforward, incurred no major complications, mitigated weight regain, and renewed clinically meaningful weight loss.

Clinicaltrials:

Gov identifier: NCT05322122.

用于重度肥胖成人袖状胃切除术翻修的磁性单吻合侧对侧十二指肠-回肠造口术:1 年疗效。
简介:我们需要一种既能减少吻合并发症,又能改善代谢/减肥手术(MBS)翻修效果的简便手术方法:我们需要既能减少吻合并发症又能改善代谢/减肥手术(MBS)翻修效果的简便手术方法:这项前瞻性单中心研究评估了新型线性磁性吻合系统(LMAS [3厘米])在实施侧对侧十二指肠吻合术(MagDI)双吻合术中的可行性、安全性和有效性,以修正临床上不理想的原发性袖带胃切除术(SG)。伴有/不伴有 2 型糖尿病(T2D)的重度肥胖患者在接受袖带胃切除术后体重下降、反弹和/或 2 型糖尿病复发的情况下,接受了复发性 MagDI。通过内窥镜将远端和近端磁体送入回肠和十二指肠,并在腹腔镜辅助下对齐。主要终点:技术可行性、1 年后的安全性(Clavien-Dindo [CD] 严重不良事件分类)。次要终点结果:2022年7月29日至2023年3月28日,24名患者(95.8%为女性,平均年龄(44.9 ± 1.5)岁,体重指数[BMI] 39.4 ± 1.3 kg/m2)接受了MagDI。100.0%的患者通过正确放置磁铁(平均手术时间为 63.5 ± 3.3 分钟)、吻合口通畅和磁铁通过肛门实现了手术的可行性。有 4 例 CD-III 轻度或中度严重 AE,0.0% 与 LMAS 或 MagDI 有关:0.0% 出现吻合口漏、阻塞、出血、感染、再次手术或死亡。平均体重指数降低了 2.1 kg/m2(P 结论:LMAS 和 MagDI 的平均体重指数降低了 2.1 kg/m2:使用新型 3 厘米 LMAS 的单吻合器 MagDI 术对临床上不理想的 SG 进行修正,技术上简单易行,未出现重大并发症,减轻了体重反弹,并重新实现了有临床意义的体重减轻:Gov 标识符:NCT05322122。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
World Journal of Surgery
World Journal of Surgery 医学-外科
CiteScore
5.10
自引率
3.80%
发文量
460
审稿时长
3 months
期刊介绍: World Journal of Surgery is the official publication of the International Society of Surgery/Societe Internationale de Chirurgie (iss-sic.com). Under the editorship of Dr. Julie Ann Sosa, World Journal of Surgery provides an in-depth, international forum for the most authoritative information on major clinical problems in the fields of clinical and experimental surgery, surgical education, and socioeconomic aspects of surgical care. Contributions are reviewed and selected by a group of distinguished surgeons from across the world who make up the Editorial Board.
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