非对称4孔法腹腔镜袖状胃切除术的临床应用

Clinical application of unsymmetrical four-port laparoscopic sleeve gastrectomy

目的探讨非对称4孔法腹腔镜袖状胃切除术(laparoscopic sleeve gastrectomy,LSG)的临床应用价值。方法回顾性分析2021年6月至2022年5月期间绵阳市中心医院收治的114例肥胖症患者的临床资料;114例患者均采用非对称4孔法行LSG。观察手术情况、术后情况以及术后3个月患者对手术切口的满意情况。结果114例患者均成功施行非对称4孔法LSG,无中转开腹。手术时间(68~160)min、(104.2±26.1)min,术中出血量(2~50)mL、(10.7±7.6)mL,术后住院时间(3~6)d、(4.0±0.7)d。114例患者中,术后发生切口脂肪液化8例(7.0%),术后24 h内出现恶心呕吐68例(59.6%),无严重并发症发生,如消化道出血、腹腔出血、胃漏等。本组114例患者均获随访,随访时间3~14个月,中位随访时间6个月。在随访中,出现脱发40例(35.1%),发生轻度贫血3例(2.6%);114例患者术后3个月随访对手术切口的满意情况:不满意2例(1.8%),满意64例(56.1%),非常满意48例(42.1%),满意率为98.2%(112/114)。结论非对称4孔法LSG安全、可行,不影响手术切口的美容效果。

Objective To investigate the clinical application value of unsymmetrical four-port laparoscopic sleeve gastrectomy(LSG).Methods The clinical data of 114 patients with obesity who were admitted to Mianyang Central Hospital from June 2021 to May 2022 were retrospective analyzed.All the 114 patients underwent unsymmetrical four-port LSG,and were observed their surgical and postoperative conditions,complications and follow-up the patient’s esthetic satisfaction of wounds at 3 months after surgery.Results All 114 patients underwent unsymmetrical four-port LSG successfully,without conversion to open surgery.The operative time was 68–160 min,average(104.2±26.1)minutes;volume of intraoperative blood loss was 2–50 mL,average(10.7±7.6)mL;the duration of postoperative hospital stay was 3–6 d,average(4.0±0.7)days.Of the 114 patients,8 patients(7.0%)had fat liquefaction of wounds,68 patients(59.6%)had postoperative nausea and vomiting in the 24 hours after operation,and all patients had no serious complications such as gastrointestinal bleeding,intraperitoneal hemorrhage,or gastric leakage.One hundred and fourteen patients were followed-up for 3–14 months,with a median follow-up of 6 months.Forty patients(35.1%)had hair loss,3 patients(2.6%)had mild anemia.Of the 114 patients,2(1.8%)were dissatisfied with the cosmetic effects of wounds,64(56.1%)were satisfied,and 48(42.1%)were very satisfied.The satisfaction rate was 98.2%(112/114).Conclusion The unsymmetrical four-port LSG is safe and feasible,it does not affect esthetic satisfaction of wounds.