腹腔镜袖状胃切除术后的胃壁厚度测量及其影响因素分析

Measurement of gastric wall thickness following laparoscopic sleeve gastrectomy and analysis of its influencing factors

目的测量肥胖患者的胃壁厚度并探讨它与患者临床病理特征的关系。方法收集2023年2–8月期间在徐州医科大学附属医院接受腹腔镜袖状胃切除术(laparoscopic sleeve gastrectomy,LSG)患者的临床病理资料。使用组织测量装置在8 g/mm^(2)的压缩压力下于3个预定位置(胃窦、胃体和胃底)测量LSG术后切除的胃组织标本的胃壁厚度,采用多重线性回归分析影响胃壁厚度的因素。结果本研究共收集到符合研究条件的232例患者,男49例,女183例;术前身体质量指数(body mass index,BMI)为28.2~61.8 kg/m^(2)、(38.4±5.3)kg/m^(2),BMI≥40 kg/m^(2)者82例、<40 kg/m^(2)者150例。232例患者的胃窦、胃体及胃底的胃壁厚度分别为(3.04±0.38)mm、(2.26±0.51)mm、(1.63±0.32)mm。多重线性回归分析结果显示,胃窦处的胃壁厚度与患者性别有关,即女性相较于男性胃窦处的胃壁厚度更薄(标准系数β=–0.152,t=–2.167,P=0.031);而胃底处的胃壁厚度与患者的BMI有关,即BMI越高胃底处的胃壁厚度越厚(标准系数β=0.153,t=2.281,P=0.023)。结论从本研究结果看,胃壁厚度与胃壁的解剖位置有关,在LSG术中针对男性和BMI更高的肥胖患在不同的切缘线解剖位置选择钉仓的大小和高度不同。

Objective To measure gastric wall thickness in patients with obesity and to investigate the relation between gastric wall thickness and clinicopathologic characteristics.Methods The clinicopathologic data of the patients who underwent laparoscopic sleeve gastrectomy(LSG)in the Affiliated Hospital of Xuzhou Medical University from February to August 2023 were collected.The gastric wall thickness of the gastric tissue specimens resected following LSG was measured by a tissue measuring device at 3 predetermined positions(gastric antrum,gastric body,and gastric fundus)at a compressive pressure of 8 g/mm^(2),and multiple linear regression was used to analyze the factors affecting the thickness of the gastric wall.Results A total of 232 patients were collected in this study,including 49 males and 183 females.Preoperative body mass index(BMI)was 28.2–61.8 kg/m^(2)with(38.4±5.3)kg/m^(2),and the patients with BMI≥40 kg/m^(2)were 82 cases and<40 kg/m^(2)were 150 cases.The thickness of the gastric wall in the gastric antrum,gastric body,and gastric fundus of 232 patients was(3.04±0.38)mm,(2.26±0.51)mm,and(1.63±0.32)mm,respectively.The results of multiple linear regression analysis showed that the thickness of the gastric wall at the gastric antrum was related to the gender of the patients,that is,the thickness of the gastric wall at the gastric antrum was thinner in the females as compared with the males(standard coefficientsβ=–0.152,t=–2.167,P=0.031),while the thickness of the gastric wall at the gastric fundus was related to the BMI of the patients,and the higher BMI,the thicker thickness of the gastric wall at the gastric fundus(standard coefficientsβ=0.153,t=2.281,P=0.023).Conclusions According to the results of this study,the thickness of the gastric wall is related to the anatomical position of the gastric wall.During LSG surgery,the size and height of the Staple lines are selected at different anatomical positions of the cutting edge for males and obese patients with higher BMI.