10-Year outcomes of marginal ulcer formation and impact of gastrojejunostomy technique in Roux-en-Y gastric bypass

IF 3.5 3区医学 Q1 SURGERY

Surgery for Obesity and Related Diseases Pub Date : 2024-12-09 DOI:10.1016/j.soard.2024.10.039

James W. Feimster M.D. , Leslie Okorji M.D. , B. Amy Paul R.N. , Kyle J. Thompson Ph.D. , Selwan Barbat M.D. , Timothy S. Kuwada M.D. , Keith S. Gersin M.D. , Roc Bauman M.D. , Iain H. Mckillop Ph.D. , Abdelrahman Nimeri M.D.

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引用次数: 0

Abstract

Background

Marginal ulcers (MUs) are potential complications following Roux-en-Y gastric bypass (RYGB) surgery. Our institution performs 3 different laparoscopic gastrojejunal anastomosis (GJA) techniques. The aim of this study was to analyze the incidence of MUs between 25-mm circular stapler (CS), linear stapler (LS), and hand-sewn (HS) GJA techniques using data collected over a 10-year period.

Methods

A retrospective single-institutional review of patients who underwent upper endoscopy after RYGB was queried (2010-2019). The type of GJA performed, complications, endoscopic interventions, smoking, and nonsteroidal anti-inflammatory drug (NSAID) use were analyzed.

Results

Overall, 2683 RYGBs were performed (1564 CS, 883 LS, and 236 HS) and an upper endoscopy was performed in 12.4% of these patients (15.4% of CS, 8.1% of LS, and 8.1% of HS patients). The incidence of MU was 6.7% (9.2% of CS, 3.3% of LS, 3.4% of HS patients). Rates of endoscopy were higher after CS versus LS and HS GJA, and incidence of MU was higher in the CS cohort versus LS and HS. Incidence of strictures was higher after CS GJA versus LS and HS, and revision of the GJA due to MU was higher following use of a CS versus LS and HS.

Conclusion

Comparing 3 common GJA techniques for RYGB, the incidence of upper endoscopy after RYGB was higher following CS GJA, and incidence of MU, stricture, and revisional surgery for MU after RYGB were high in the CS cohort.

查看原文本刊更多论文

Roux-en-Y胃旁路术边缘溃疡形成的10年预后及胃空肠造口技术的影响。

背景：边缘溃疡（MUs）是Roux-en-Y胃旁路手术（RYGB）后的潜在并发症。本院有三种不同的腹腔镜胃空肠吻合技术。本研究的目的是分析25毫米圆形订书机（CS），线性订书机（LS）和手工缝制（HS） GJA技术之间MUs的发生率，使用收集的数据超过10年。方法：对2010-2019年RYGB术后接受上内镜检查的患者进行回顾性单机构评价。分析GJA的类型、并发症、内镜干预、吸烟和非甾体抗炎药（NSAID）的使用。结果：总体而言，共进行了2683例rygb(1564例CS， 883例LS和236例HS)，其中12.4%的患者（15.4% CS， 8.1% LS和8.1% HS患者）进行了上颌内窥镜检查。MU的发生率为6.7% （CS为9.2%，LS为3.3%，HS为3.4%）。与LS和HS GJA相比，CS组的内窥镜检查率更高，CS组的MU发生率高于LS和HS组。与LS和HS相比，使用CS GJA后狭窄的发生率更高，使用CS与LS和HS相比，由于MU引起的GJA修正更高。结论：比较3种常用GJA技术对RYGB的影响，CS GJA后RYGB后上内镜的发生率更高，且RYGB后MU、狭窄和MU翻修手术的发生率在CS组较高。

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

Surgery for Obesity and Related Diseases 医学-外科

CiteScore

6.70

自引率

12.90%

发文量

570

审稿时长

56 days

期刊介绍： Surgery for Obesity and Related Diseases (SOARD), The Official Journal of the American Society for Metabolic and Bariatric Surgery (ASMBS) and the Brazilian Society for Bariatric Surgery, is an international journal devoted to the publication of peer-reviewed manuscripts of the highest quality with objective data regarding techniques for the treatment of severe obesity. Articles document the effects of surgically induced weight loss on obesity physiological, psychiatric and social co-morbidities.