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首页> 外文期刊>Updates in Surgery >Laparoscopic mini-gastric bypass: short-term single-institute experience
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Laparoscopic mini-gastric bypass: short-term single-institute experience

机译：腹腔镜微型胃旁路术：短期的单机构经验

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The elevated variety of procedures proposed for surgical treatment of obesity in the last few years suggests the necessity to find an ideal operation. Laparoscopic mini-gastric bypass (LMGB) was developed to obtain better results with lesser morbidity and mortality. LMGB was introduced by Rutledge, in 1997, and it consists of a long lesser-curvature tube with a terminolateral gastroenterostomy 180 cm distal to the Treitz ligament. From July 1995 to May 2011 we have performed 552 bariatric operations, among them we have operated 197 laparoscopic mini-gastric bypass (Fig. 1). There were 147 female (75%) and 50 male (25%) with the mean age of 37.9 years (range 20–55) and the mean BMI of 52.9 kg/m2. All procedures were completed laparoscopically, without conversion and the mean operative time was 120 min (range from 90 to 170 min). The average postoperative stay was 5.0 days. We report one case of mortality for pulmonary septic complications. Major complications were two cases of pulmonary embolism (treated in ICU), six cases of melena on seventh postoperative day and three cases of anastomotic ulcers resolved with high doses of PPI. We registered a significant reduction of BMI and percentage of excess weight after surgery with a significant improvement in obesity-related comorbidities including blood pressure, hyperglycemia, blood lipid, uric acid, and liver function. An ideal weight loss operation should be effective, easy to perform and safe. Laparoscopic Roux-en-Y Gastric Bypass is actually the “gold-standard” technique but LMGB seems to be an attractive alternative: shorter operative time, with less morbidity and mortality, easier to teach and to perform. Another advantage could be the presence of a single anastomosis alone reducing the possibility of leaks. Fig. 1 Totality of bariatric procedures in our experience
机译：在过去的几年中，提出了用于肥胖症的外科手术的各种程序的增加提示了寻找理想手术的必要性。腹腔镜微型胃旁路术（LMGB）的开发是为了以较低的发病率和死亡率获得更好的结果。 LMGB由Rutledge于1997年推出，它由一根曲率较小的长管组成，该管在Treitz韧带的远端180厘米处进行了肠胃侧肠胃吻合术。从1995年7月到2011年5月，我们进行了552次减肥手术，其中我们进行了197例腹腔镜微型胃旁路手术（图1）。平均年龄37.9岁（20-55岁），平均BMI为52.9 kg / m2，其中有147名女性（占75％）和50名男性（占25％）。所有手术均在腹腔镜下完成，无需转换，平均手术时间为120分钟（90至170分钟）。术后平均住院时间为5.0天。我们报告了1例因肺脓毒症并发症而死亡的病例。主要并发症为2例肺动脉栓塞（在ICU中治疗），6例术后第七天的黑斑病和3例高剂量PPI消解的吻合溃疡。手术后，我们发现BMI显着降低，且超重百分比显着降低，与肥胖相关的合并症（包括血压，高血糖，血脂，尿酸和肝功能）也得到了显着改善。理想的减肥手术应该有效，易于执行且安全。腹腔镜Roux-en-Y胃旁路术实际上是“金标准”技术，但LMGB似乎是一种有吸引力的替代方法：手术时间更短，发病率和死亡率更低，更易于教导和执行。另一个优势可能是仅存在单个吻合术，从而减少了渗漏的可能性。图1我们经验中的减肥手术总数

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