纵向胃切除术治疗非减肥适应症。

IF 1.3 Q3 SURGERY
Minimally Invasive Surgery Pub Date : 2021-05-06 eCollection Date: 2021-01-01 DOI:10.1155/2021/9962130
Oluwatobi O Onafowokan, Aboubakr Khairat, Mohammad Jamal, Hemant Chatrath, Hugo J R Bonatti
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引用次数: 0

摘要

背景:袖式胃切除术是最常用的减肥手术。腹腔镜纵向胃切除术(LLG)可能适用于其他适应症。患者和方法。年龄分别为67岁、72岁、77岁和80岁的两男两女因非肥胖适应症接受了LLG治疗,其中两名体重正常,一名病毒性,一名严重肥胖。结果:手术前与患者讨论了LLG,但在考虑其他手术选择后,在手术中决定LLG。一个宽袖子在一个42法国布吉被创造与主线被缝制与运行3-0丝绸。适应症包括内镜夹闭失败的出血的十二指肠病变,食管旁疝修补时发现的眼底腺息肉,怀疑为平滑肌肉瘤转移的眼底结节,最终病理显示脾肿大,胃明显扩张伴胃器官轴性扭转。3名患者顺利康复;这位严重肥胖的病人体重暂时减轻,但两年后死于中风。最后一位患者由于袖内的α环而出现吞咽困难,这是通过内窥镜支架置入治疗的。该装置随后移动并在腹腔镜下移除,并进行侧侧胃造口术以拉直α环。患者对食物的耐受性较好,夜间PEG管饲后体重增加,但继续大量吸烟。一年后,他死于慢性阻塞性肺病恶化。结论:LLG似乎是一种适合于各种胃病理的干预措施。鼓励对住院医师和研究员进行LLG微创手术步骤的培训。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Longitudinal Gastrectomy for Nonbariatric Indications.

Longitudinal Gastrectomy for Nonbariatric Indications.

Longitudinal Gastrectomy for Nonbariatric Indications.

Longitudinal Gastrectomy for Nonbariatric Indications.

Background: Sleeve gastrectomy is the most commonly performed bariatric procedure. Laparoscopic longitudinal gastrectomy (LLG) may be indicated for other indications. Patients and Methods. Two men and two women aged 67, 72, 77, and 80 years underwent LLG for nonbariatric indications with two having normal weight, one being cachectic, and one severely obese.

Results: LLG was discussed with patients prior to surgery, but decision for LLG was made during surgery after contemplating other surgical options. A wide sleeve over a 42 French bougie was created with the staple line being oversewn with running 3-0 silk. Indications included a bleeding Dieulafoy lesion that failed endoscopic clipping, fundus gland polyposis found during paraesophageal hernia repair, fundus nodules suspected to be leiomyosarcoma metastases revealing splenosis on final pathology, and significant gastric dilatation associated with organoaxial gastric volvulus. Three patients had an uneventful recovery; the severely obese patient temporarily lost weight but died after two years from a stroke. The last patient developed dysphagia due to an alpha-loop in the sleeve, which was managed by endoscopic stenting. The device subsequently migrated and was laparoscopically removed, with a side-side gastrogastrostomy performed to straighten the alpha-loop. The patient tolerated food better and with overnight PEG tube feeds gained weight but continued heavy smoking. He died after one year from COPD exacerbation.

Conclusion: LLG seems to be an appropriate intervention for various gastric pathologies. Training of residents and fellows in the minimally invasive surgical steps of LLG is encouraged.

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来源期刊
CiteScore
3.00
自引率
0.00%
发文量
8
审稿时长
16 weeks
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