距幽门 6 厘米与 2 厘米切除边缘对腹腔镜袖状胃切除术超重和并发症发生率的影响:九年经验

Junaid Khan Lodhi, Saba Tahir Bukhari, Asma Munaf, Saima Amjad, Muhammad Zubair, Fawad Hameed, Muhammad Shoaib, Muhammad Khurram Jameel
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Small (2cm) and large (6cm) distance of resection margin from pylorus are both being used for neogastric sleeve formation however what is optimal distance remains controversial.\nAims & Objectives: To assess excess weight loss results and complication rate with 6cm and 2cm distance of staple line from pylorus during a prolonged surveillance period.\nPlace and Duration of Study: This retrospective cohort study was conducted at Fatima Memorial Hospital from Dec 2013 to Dec 2022 spanning 9 years.\nMaterial & Methods: Medical records of 50 morbidly obese patients aged 41- 50 yrs were segregated into two groups of 25 each based on the LSG procedure conducted. Group 1 had LSG with 6cm resection margin from pylorus while group 2 had a staple line distance of 2cm from pylorus for neogastric sleeve formation. The patients were subsequently followed up for excess weight loss (EXL) and BMI at 6 months, 1 year, 2 years, 3 years & 4-year interval. Data was entered and analyzed using SPSS version 21.P value ? 0.05 was considered significant.\nResults: EWL in Group 1 & 2 was 39.2± 6.77kg & 41.9± 4.35kg at 6 months,73.64± 6.49kg & 71.06± 7.77kg at 1 year,\n65.52± 5.53kg & 63.92± 7.07kg at 2 years,58.16± 4.97kg & 57.28± 5.75kg at 3 years and 55.48± 3.39kg & 55.36±\n3.72kg for 4 years were, not significant statistically. BMI in group 1 & 2 were 39.47± 5.11 & 35.88± 4.40 at 6 months,\n29.22± 2.68 & 29.12± 2.00 at 1 year, 25.44± 1.96 & 24.73± 2.86 at 2 years, 22.84± 1.79 & 22.40±2.20 at 3 years and\n21.66± 1.32, 21.67± 1.62 at 4 years were found to be statistically insignificant.\nConclusion: With regards to extra weight loss, distance of resection margin from pylorus of 2cm or 6cm have identical effects but the latter has lowest complication incidence after 4 yrs of surveillance. Hence, a distance of 6cm is favoured to ensure safety of LSG for morbidly obese patients. 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引用次数: 0

摘要

导言:胃袖状切除术(LSG)是治疗病态肥胖症的唯一减肥手术。新胃套管成形术的切除边缘距幽门的距离有小(2 厘米)和大(6 厘米)两种,但最佳距离是多少仍存在争议:评估在长期监测期间,缝合线距幽门6厘米和2厘米的超重结果和并发症发生率:这项回顾性队列研究于 2013 年 12 月至 2022 年 12 月在法蒂玛纪念医院进行,历时 9 年:将 50 名 41-50 岁的病态肥胖患者的病历根据 LSG 手术分为两组,每组 25 人。第 1 组进行了切除幽门边缘 6 厘米的 LSG 手术,而第 2 组则进行了新胃袖状手术,其缝合线距离幽门 2 厘米。随后,分别在 6 个月、1 年、2 年、3 年和 4 年对患者的超重情况(EXL)和体重指数(BMI)进行随访。数据使用 SPSS 21 版进行输入和分析。结果:结果:第 1 组和第 2 组 6 个月时的 EWL 分别为 39.2±6.77kg 和 41.9±4.35kg,1 年时分别为 73.64±6.49kg 和 71.06±7.77kg,2 年时分别为 65.52±5.53kg和 63.92±7.07kg,3 年时分别为 58.16±4.97kg和 57.28±5.75kg,4 年时分别为 55.48±3.39kg和 55.36±3.72kg,差异无统计学意义。第 1 组和第 2 组的体重指数在 6 个月时分别为 39.47± 5.11 和 35.88± 4.40,1 年时分别为 29.22± 2.68 和 29.12±2.00,2 年时分别为 25.44± 1.96 和 24.73±2.86,3 年时分别为 22.84± 1.79 和 22.40±2.20,4 年时分别为 21.66±1.32、21.67±1.62,均无统计学意义:就额外体重减轻而言,切除边缘距幽门 2 厘米或 6 厘米的效果相同,但后者在 4 年监测后的并发症发生率最低。因此,为确保病态肥胖患者胃切除术的安全性,最好选择 6 厘米的距离。这项研究的结果将有助于减肥外科医生以安全、成功的方式改进 LSG 技术,从而有效减轻病态肥胖患者的体重。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Effects of 6cm versus 2cm Resection Margin from Pylorus on Excess Weight Loss & Complication Rate for Laparo- Scopic Sleeve Gastrectomy: A Nine-Year Experience
Introduction: LSG is the gold standard sole bariatric procedure for morbid obesity. Small (2cm) and large (6cm) distance of resection margin from pylorus are both being used for neogastric sleeve formation however what is optimal distance remains controversial. Aims & Objectives: To assess excess weight loss results and complication rate with 6cm and 2cm distance of staple line from pylorus during a prolonged surveillance period. Place and Duration of Study: This retrospective cohort study was conducted at Fatima Memorial Hospital from Dec 2013 to Dec 2022 spanning 9 years. Material & Methods: Medical records of 50 morbidly obese patients aged 41- 50 yrs were segregated into two groups of 25 each based on the LSG procedure conducted. Group 1 had LSG with 6cm resection margin from pylorus while group 2 had a staple line distance of 2cm from pylorus for neogastric sleeve formation. The patients were subsequently followed up for excess weight loss (EXL) and BMI at 6 months, 1 year, 2 years, 3 years & 4-year interval. Data was entered and analyzed using SPSS version 21.P value ? 0.05 was considered significant. Results: EWL in Group 1 & 2 was 39.2± 6.77kg & 41.9± 4.35kg at 6 months,73.64± 6.49kg & 71.06± 7.77kg at 1 year, 65.52± 5.53kg & 63.92± 7.07kg at 2 years,58.16± 4.97kg & 57.28± 5.75kg at 3 years and 55.48± 3.39kg & 55.36± 3.72kg for 4 years were, not significant statistically. BMI in group 1 & 2 were 39.47± 5.11 & 35.88± 4.40 at 6 months, 29.22± 2.68 & 29.12± 2.00 at 1 year, 25.44± 1.96 & 24.73± 2.86 at 2 years, 22.84± 1.79 & 22.40±2.20 at 3 years and 21.66± 1.32, 21.67± 1.62 at 4 years were found to be statistically insignificant. Conclusion: With regards to extra weight loss, distance of resection margin from pylorus of 2cm or 6cm have identical effects but the latter has lowest complication incidence after 4 yrs of surveillance. Hence, a distance of 6cm is favoured to ensure safety of LSG for morbidly obese patients. And the findings of this study will help bariatric surgeons to improve technique of LSG in a safe and successful way for effective weight loss in morbidly obese patients.
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