Laparoscopic ileopexy for afferent loop syndrome after restorative proctocolectomy-a retrospective case series.

IF 2.5 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY
Simone Hyldgaard Andersen, Sanne Harsløf, Anders Tøttrup
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引用次数: 0

Abstract

Background: To study the effect of laparoscopic ileopexy in patients with afferent-loop syndrome (ALS) after restorative proctocolectomy (RP).

Method: Ileopexy has been the treatment of choice in patients with ALS for the last 5 years at our department. All patients who had undergone ileopexy for ALS between January 2019 and August 2023 were identified. Data were extracted from the medical records. All patients were contacted and asked standardized questions regarding symptoms of ALS. A symptom score was calculated and compared before surgery and at the last follow-up.

Results: Ten patients, who had undergone ileopexy for ALS, were identified. Eight of these (80%) had been admitted with small bowel obstruction due to ALS. The remaining 2 patients had other symptoms indicative of ALS. In all patients, ileopexy was immediately effective in reducing symptoms. Symptoms recurred after 16.5 weeks (2-80) in 8 patients. Repeat laparoscopy showed that the ileopexy had slipped in 6 of these. Six had a new ileopexy with mesh. Later, one of these developed recurrent symptoms and had a new mesh ileopexy performed. No mesh complications were seen. Symptom score was reduced from 6.5 (1-9) to 2 (0-7) (p = 0.02) at the last follow-up.

Conclusions: In this study, ileopexy is effective in reducing symptoms of ALS after RP. In a high proportion of patients, it is necessary to use mesh to ensure long-term fixation of the ileum.

腹腔镜回肠切除术治疗恢复性直肠结肠切除术后的传入环综合征--回顾性病例系列。
背景:研究腹腔镜回肠吻合术对直肠切除术(RP)后传入环综合征(ALS)患者的影响:研究恢复性直肠结肠切除术(RP)后传入环综合征(ALS)患者腹腔镜回肠吻合术的效果:方法:过去5年来,回肠吻合术一直是我科治疗ALS患者的首选方法。所有在 2019 年 1 月至 2023 年 8 月期间因 ALS 而接受回肠吻合术的患者均被识别出来。从病历中提取数据。与所有患者取得联系,并向其询问有关 ALS 症状的标准化问题。计算症状评分,并在手术前和最后一次随访时进行比较:结果:10 名患者因 ALS 接受了回肠吻合术。其中 8 人(80%)因 ALS 引起的小肠梗阻而入院。其余 2 名患者有其他 ALS 症状。所有患者的回肠切除术都能立即有效地减轻症状。8 名患者的症状在 16.5 周(2-80 周)后复发。再次腹腔镜检查显示,其中 6 名患者的回肠吻合术发生了滑脱。其中 6 人重新进行了带网片的回肠吻合术。后来,其中一名患者症状复发,又进行了新的网片回肠吻合术。没有发现网片并发症。最后一次随访时,症状评分从 6.5 分(1-9 分)降至 2 分(0-7 分)(p = 0.02):在这项研究中,回肠吻合术能有效减轻 RP 术后 ALS 的症状。结论:在这项研究中,回肠吻合术能有效减轻 RP 术后 ALS 的症状,但有很大一部分患者需要使用网片来确保回肠的长期固定。
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
CiteScore
4.90
自引率
3.60%
发文量
206
审稿时长
3-8 weeks
期刊介绍: The International Journal of Colorectal Disease, Clinical and Molecular Gastroenterology and Surgery aims to publish novel and state-of-the-art papers which deal with the physiology and pathophysiology of diseases involving the entire gastrointestinal tract. In addition to original research articles, the following categories will be included: reviews (usually commissioned but may also be submitted), case reports, letters to the editor, and protocols on clinical studies. The journal offers its readers an interdisciplinary forum for clinical science and molecular research related to gastrointestinal disease.
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