The impact of the surgical technique on stenosis after laparoscopic sleeve gastrectomy: a single center study on 5235 patients.

IF 1.3 Q3 Medicine

Minerva chirurgica Pub Date : 2020-11-09 DOI:10.23736/S0026-4733.20.08505-3

P. Termine, Cristian E Boru, F. Turcu, C. Copăescu

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引用次数: 0

Abstract

BACKGROUND Laparoscopic Sleeve Gastrectomy (LSG) has gained worldwide popularity in the last 10 years as self alone bariatric procedure. Symptomatic Stenosis (SS) is a potential severe postoperative complication and it can be divided in organic stenosis (OS) and functional stenosis (FS). The aim of this paper is to propose a modified surgical technique to prevent FS. METHODS A retrospective review on 5235 LSG performed in Ponderas Academic Hospital between January 2011 and December 2019, searched FS in two consecutive patients groups, divided based on the modified surgical technique introduced in 2015, with fixation of the gastric tube to the pre-pancreatic fascia and stapler line's over-sewn running suture. RESULTS Group A (2011-2014) included 1332 LSG, 16 SS were registered (1.2%), 7 OS and 9 FS; 3903 LSG included in group B (2015-2019), counting for 37 SS (0.95%), 27 OS and 10 FS. A statistically significant difference between the 2 groups was observed for the FS incidence (p=0.03), while it was non-significant for the OS (p=0.52) and the total number of SS (p=0.43). The endoscopic approach was used in forty-eight SS (90.5%) with a successful rate of 83%, while specifically for the FS it was 100%; only one complication was registered during endoscopic treatment, that required further surgical solution. CONCLUSIONS fixation of the gastric tube to the pre-pancreatic fascia and stapler line's over-sewn running suture during LSG, introduced lately, are beneficial in preventing the postoperative functional stenosis of the LSG, contributing to the improvement of the patient's quality of life.

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手术技术对腹腔镜袖状胃切除术后狭窄的影响：5235例患者的单中心研究。

背景腹腔镜袖状胃切除术（LSG）在过去10年中作为一种单独的减肥手术在世界范围内越来越受欢迎。症状性狭窄（SS）是一种潜在的严重术后并发症，可分为器质性狭窄（OS）和功能性狭窄（FS）。本文的目的是提出一种预防FS的改良手术技术。METHODSA对2011年1月至2019年12月在Ponderas Academic Hospital进行的5235例LSG进行了回顾性审查，在两个连续的患者组中搜索FS，根据2015年引入的改良手术技术进行划分，将胃导管固定在胰前筋膜上，缝合线的上缝运行缝线。结果A组（2011-2014）包括1332名LSG，16名SS注册（1.2%），7名OS和9名FS；B组（2015-2019）包括3903例LSG，包括37例SS（0.95%）、27例OS和10例FS。两组FS发生率（p=0.03）存在统计学显著差异，而OS（p=0.52）和SS总数（p=0.43）无显著差异。48例SS采用内镜入路（90.5%），成功率为83%，而FS的成功率为100%；在内镜治疗过程中，只有一个并发症需要进一步的手术解决。结论近年来在LSG术中采用胰前筋膜固定和缝合线超缝运行缝合，有利于预防LSG术后功能性狭窄，有助于提高患者的生活质量。

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

Minerva chirurgica 医学-外科

CiteScore

1.40

自引率

0.00%

发文量

审稿时长

>12 weeks

期刊介绍： Minerva Chirurgica publishes scientific papers on surgery. Manuscripts may be submitted in the form of editorials, original articles, review articles, case reports, special articles, letters to the Editor and guidelines. The journal aims to provide its readers with papers of the highest quality and impact through a process of careful peer review and editorial work.