Background: Laparoscopic Roux-en-Y gastric bypass (LRYGB) is an effective and well-accepted procedure for the treatment of morbid obesity but has complications such as stenosis of the gastroenteroanastomosis (GE), GE ...Background: Laparoscopic Roux-en-Y gastric bypass (LRYGB) is an effective and well-accepted procedure for the treatment of morbid obesity but has complications such as stenosis of the gastroenteroanastomosis (GE), GE leak, surgical site infection, and stapling malfunction. This study evaluated the efficiency of weight loss and the incidence of short- and mid-term postoperative complications in patients undergoing LRYGB in which anastomosis was performed using a linear stapler (LSA) or a circular stapler (CSA). Methods: Prospective observational study conducted between April 2016 and March 2019. The data were extracted from a hospital database that includes patients undergoing LRYGB in two different GE techniques, assessing postoperative complications and excess body weight loss. Results: Data from 457 patients were analyzed, of which 216 were in the LSA group and 241 were in the CSA group. There were four cases (1.7%) of GE stenosis in the CSA group and only one (0.5%) in the LSA group. Stapler malfunction occurred in both groups: CSA (0.4%) and LSA (0.5%), and a GE leak developed only in the CSA group (0.4%). Surgical site infection was found in five patients in the CSA group (2.1%) and two in the LSA group (0.9%). No statistical difference was found between the two groups in any of the variables analyzed (p > 0.05). Conclusions: Both stapling techniques resulted in a similar loss of excess body weight during the follow-up period. Although the LSA group had fewer total complications, these were not statistically significant, which substantiates the fact that both techniques are safe and feasible, provided they are performed by a surgeon with a long learning curve in laparoscopic bariatric surgery.展开更多
AIM:To introduce a simple and safe anvil insertion technique to esophagus during laparoscopic total gastrectomy(LTG).METHODS:Between July 2010 and December 2012,58 consecutive patients with early gastric cancer underw...AIM:To introduce a simple and safe anvil insertion technique to esophagus during laparoscopic total gastrectomy(LTG).METHODS:Between July 2010 and December 2012,58 consecutive patients with early gastric cancer underwent LTG were enrolled.We performed a simple and safe Roux-en-Y esophagojejunostomy using the double stapling technique to all patients.Then patients’characteristics,perioperative outcome and histopathologic data were analyzed retrospectively.RESULTS:The mean age and body mass index were59.3±9.7 years and 22.7±2.6 kg/m2.The mean operation,reconstruction and anvil insertion times(from gastric incision to linear stapling)were 251.8±57.0,43.1±2.8 and 4.2±1.9 min,respectively.Intraoperative blood loss was 204.6±156.3 m L and there was no open conversion.The postoperative complications were in 8 cases(delayed gastric emptying in 4 cases,pulmonary complication in 2cases,pancreatitis in 1 case,anastomotic stricture in 1case).Anastomotic stricture occurred after discharge and was recovered by endoscopic intervention.The patients were discharged at a mean of 9.6±2.0 d after surgery.Neither leakage nor bleeding from the esophagojejunostomy occurred postoperatively.The mean proximal margin of specimen was 2.7±2.8 cm CONCLUSION:Roux-en Y esophagojejunostomy usingthe double stapling technique is simple and rapid,and it may offer a solid,alternative reconstruction method for LTG or proximal gastrectomy.展开更多
文摘Background: Laparoscopic Roux-en-Y gastric bypass (LRYGB) is an effective and well-accepted procedure for the treatment of morbid obesity but has complications such as stenosis of the gastroenteroanastomosis (GE), GE leak, surgical site infection, and stapling malfunction. This study evaluated the efficiency of weight loss and the incidence of short- and mid-term postoperative complications in patients undergoing LRYGB in which anastomosis was performed using a linear stapler (LSA) or a circular stapler (CSA). Methods: Prospective observational study conducted between April 2016 and March 2019. The data were extracted from a hospital database that includes patients undergoing LRYGB in two different GE techniques, assessing postoperative complications and excess body weight loss. Results: Data from 457 patients were analyzed, of which 216 were in the LSA group and 241 were in the CSA group. There were four cases (1.7%) of GE stenosis in the CSA group and only one (0.5%) in the LSA group. Stapler malfunction occurred in both groups: CSA (0.4%) and LSA (0.5%), and a GE leak developed only in the CSA group (0.4%). Surgical site infection was found in five patients in the CSA group (2.1%) and two in the LSA group (0.9%). No statistical difference was found between the two groups in any of the variables analyzed (p > 0.05). Conclusions: Both stapling techniques resulted in a similar loss of excess body weight during the follow-up period. Although the LSA group had fewer total complications, these were not statistically significant, which substantiates the fact that both techniques are safe and feasible, provided they are performed by a surgeon with a long learning curve in laparoscopic bariatric surgery.
基金Supported by Pusan National Universitythe National R&D Program for Cancer Control at the Ministry for Health,Welfare and Family Affairs,South Korea,No.0920050
文摘AIM:To introduce a simple and safe anvil insertion technique to esophagus during laparoscopic total gastrectomy(LTG).METHODS:Between July 2010 and December 2012,58 consecutive patients with early gastric cancer underwent LTG were enrolled.We performed a simple and safe Roux-en-Y esophagojejunostomy using the double stapling technique to all patients.Then patients’characteristics,perioperative outcome and histopathologic data were analyzed retrospectively.RESULTS:The mean age and body mass index were59.3±9.7 years and 22.7±2.6 kg/m2.The mean operation,reconstruction and anvil insertion times(from gastric incision to linear stapling)were 251.8±57.0,43.1±2.8 and 4.2±1.9 min,respectively.Intraoperative blood loss was 204.6±156.3 m L and there was no open conversion.The postoperative complications were in 8 cases(delayed gastric emptying in 4 cases,pulmonary complication in 2cases,pancreatitis in 1 case,anastomotic stricture in 1case).Anastomotic stricture occurred after discharge and was recovered by endoscopic intervention.The patients were discharged at a mean of 9.6±2.0 d after surgery.Neither leakage nor bleeding from the esophagojejunostomy occurred postoperatively.The mean proximal margin of specimen was 2.7±2.8 cm CONCLUSION:Roux-en Y esophagojejunostomy usingthe double stapling technique is simple and rapid,and it may offer a solid,alternative reconstruction method for LTG or proximal gastrectomy.
