腹腔镜袖状胃切除术治疗肥胖及其并发症20例报告

Laparoscopic sleeve gastrectomy for obesity and its complications:report of 20 cases

目的:探讨腹腔镜袖状胃切除术治疗肥胖及其并发症的可行性。方法:回顾分析2020年5月至2021年5月接受腹腔镜袖状胃切除术治疗的20例肥胖患者的临床资料,整理术前(性别、年龄、体重、体重指数、糖化血红蛋白、甘油三脂及血压)、术中(出血量、手术时间)、术后(术后胃残端瘘、出血、死亡例数及术后6个月随访时患者的体重、体重指数、糖化血红蛋白、甘油三酯及血压)相关指标,并进行统计学分析。结果:20例患者均成功完成腹腔镜袖状胃切除术,术中出血量平均(25.65±7.04)mL,手术时间平均(63.85±13.81)min;术后2例患者出现消化道出血,无术后胃瘘及围手术期死亡病例。术后6个月随访,患者体重较术前平均下降(22.15±8.37)kg,体重指数平均下降(7.55±2.21)kg/m 2,血脂水平均降至正常,7例高血压患者中5例收缩压完全降至正常,另2例血压较术前不同程度降低;2例2型糖尿病患者的糖化血红蛋白较术前均下降。结论:腹腔镜袖状胃切除术治疗肥胖及其相关并发症安全、有效,可作为常规术式在基层医院开展。

Objective:To investigate the feasibility of laparoscopic sleeve gastrectomy(LSG)in the treatment of obesity and its complications.Methods:Clinical data of 20 obese patients who underwent LSG from May 2020 to May 2021 were retrospectively analyzed.The data of preoperative(gender,age,weight,body mass index,glycosylated hemoglobin,triglycerides and blood pressure),intraoperative(blood loss and operation time)and postoperative(postoperative gastric stump fistula,bleeding,death,and body weight,body mass index,glycosylated hemoglobin,triglyceride and blood pressure at the follow-up visit 6 months after surgery)related indicators were collected and statistically analyzed.Results:All 20 cases underwent LSG successfully.The average blood loss was(25.65±7.04)mL,and the average operation time was(63.85±13.81)min.2 patients experienced gastrointestinal bleeding after surgery,without postope-rative gastric fistula or perioperative death.At 6 months after surgery,the average body weight decreased by(22.15±8.37)kg,body mass index decreased by(7.55±2.21)kg/m 2,and blood lipid levels all reduced to normal.Systolic blood pressure of 5 in the 7 patients with hypertension completely decreased to normal,and the other 2 patients decreased to different degrees than before surgery.Glycosylated hemoglobin decreased in 2 patients with type 2 diabetes.Conclusion:LSG is safe and effective in the treatment of obesity and its related complications,and can be carried out as a routine operation in primary hospitals.