单切口腹腔镜下青少年可调节胃束置入的初步经验：安全可行。

IF 1.3 4区医学 Q3 PEDIATRICS

Archives De Pediatrie Pub Date : 2025-04-01 DOI:10.1016/j.arcped.2024.08.004

Sarah Amar , Blaise Corbery , François Bastard , Guillaume Podevin , Françoise Schmitt

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引用次数: 0

摘要

背景：鉴于微创手术提供的美容改善，它似乎特别适合青少年。本研究报告了我们首次使用单套管针入路进行单切口腹腔镜手术治疗可调节胃束带（sls - agb）的经验，并与传统的四套管针腹腔镜手术相比，评估了其安全性和有效性。方法：回顾性分析本中心2014 - 2019年接受SILS-AGB或常规腹腔镜可调节胃束带（CL-AGB）治疗的青少年患者的资料。术前和术后体重和肥胖相关合并症的数据被用来评估手术干预的效果。比较SILS组和CL组的手术时间、镇痛药使用、住院时间和并发症的围手术期和术后数据，并评估疤痕质量。结果：总体而言，12例手术时平均体重指数（BMI）为43.3 kg/m-²（37.0-55.5）的患者被纳入SILS-AGB组，与14例接受经典腹腔镜检查的患者（CL-AGB组）相比，初始BMI为39.5 kg/m-²（32.0-49.8）。CL-AGB组中位手术时间为82 min (55 ~ 140)， sil - agb组中位手术时间为106 min (75 ~ 159) （p = 0.04）。SILS-AGB组术后恢复更好，平均3级静脉镇痛时间为1.8±0.4天（vs. 2.4±0.6天，p = 0.02），中位住院时间为2天（2-3）vs. 3天（2-5）（p = 0.0005）。中期随访显示，在减肥方面，两组患者12个月时的平均BMI为38.5±6.0 kg m-1kg m-1²，高胰岛素血症的缓解（术前92.3%，6个月时48%）效果相当。结论：SILS植入AGB与CL一样安全有效，只是手术时间稍长。SILS与单个疤痕的更快恢复和更好的美容效果相关。

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Preliminary experience of single-incision laparoscopic placement of adjustable gastric band in adolescents: Safe and feasible

Background

Minimally invasive surgery seems particularly suited to adolescents in view of the cosmetic improvements it provides. This study reports on our first experience of single-incision laparoscopic surgery for adjustable gastric banding (SILS-AGB) using a single-trocar approach and evaluates its safety and efficacy as compared with conventional four-trocar laparoscopy.

Methods

The data of adolescent patients who underwent SILS-AGB or conventional laparoscopy for adjustable gastric banding (CL-AGB) between 2014 and 2019 in our center were reviewed. Pre- and postoperative data on weight- and obesity-associated comorbidities were used to assess the efficacy of the surgical intervention. Perioperative and postoperative data on the duration of surgery, use of analgesics, hospital stay, and complications were compared between the SILS and CL groups along with an assessment of scar quality.

Results

Overall, 12 patients, with a mean body mass index (BMI) of 43.3 kg/m^-² (37.0–55.5) at surgery were included in the SILS-AGB group and compared with 14 patients who underwent classic laparoscopy (CL-AGB group) and had an initial BMI of 39.5 kg/m^-² (32.0–49.8). Median surgery time was 82 min (55–140) in the CL-AGB group and 106 min (75–159) in the SILS-AGB group (p = 0.04). Postoperative recovery was better in the SILS-AGB group with a mean duration of level-3 intravenous analgesia of 1.8 ± 0.4 days (vs. 2.4 ± 0.6 days, p = 0.02) and a median duration of hospitalization of 2 days (2–3) versus 3 days (2–5) (p = 0.0005). Mid-term follow-up showed equivalent efficacy in terms of weight loss, with a mean BMI at 12 months of 38.5 ± 6.0 kg m^-1kg m^-1² in both groups, and resolution of hyperinsulinism (92.3 % before surgery vs. 48 % at 6 months).

Conclusion

SILS for AGB placement appears to be as safe and effective as CL despite a slightly longer operative time. SILS was associated with faster recovery and better cosmetic results with a single scar.

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来源期刊

Archives De Pediatrie 医学-小儿科

CiteScore

2.80

自引率

5.60%

发文量

106

审稿时长

24.1 weeks

期刊介绍： Archives de Pédiatrie publishes in English original Research papers, Review articles, Short communications, Practice guidelines, Editorials and Letters in all fields relevant to pediatrics. Eight issues of Archives de Pédiatrie are released annually, as well as supplementary and special editions to complete these regular issues. All manuscripts submitted to the journal are subjected to peer review by international experts, and must: Be written in excellent English, clear and easy to understand, precise and concise; Bring new, interesting, valid information - and improve clinical care or guide future research; Be solely the work of the author(s) stated; Not have been previously published elsewhere and not be under consideration by another journal; Be in accordance with the journal''s Guide for Authors'' instructions: manuscripts that fail to comply with these rules may be returned to the authors without being reviewed. Under no circumstances does the journal guarantee publication before the editorial board makes its final decision. Archives de Pédiatrie is the official publication of the French Society of Pediatrics.