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首页> 外文期刊>Bariatric Surgical Patient Care >Stricture Rates After Gastric Bypass with Hand- Sewn Anastomosis
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Stricture Rates After Gastric Bypass with Hand- Sewn Anastomosis

机译：手工缝合吻合术在胃旁路术后的并发症发生率

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Background: Anastomotic strictures at the gastrojejunal anastomosis (GJA) are relatively common after a laparoscopic Roux-en-Y gastric bypass (LRYGB). There are three different ways to perform a GJA: circular stapled (CS), linear stapled (LS), and hand-sewn (HS). The CS technique provides the most standard diameter, and the LS and HS techniques can be standardized by using a bougie to calibrate the diameter of the anastomosis. However, they can all become strictured. This study examines the stricture rate of a hand-sewn GJA over a 4-year period. Methods: A prospectively maintained database was used to retrospectively evaluate patient outcomes at our bariatric center. This database was evaluated for strictures. The gastric bypasses were performed over a 4-year period by a single surgeon. The technique remained standard over the study period. This was a two-layered HS anastomosis with four different sutures of an absorbable suture (2.0 VICRYL (R)). Inclusion criteria were primary laparoscopic gastric bypasses. Exclusion criteria were revisions and conversions to open procedures and combined procedures. Results: From 2010 to 2013, there were 454 primary LRYGB. The overall stricture rate was 3.1% with 14 patients. This varied by year from a low of 0% in 2013 to 4.2% in 2012. The average time to stricture was 57.5 days with a standard deviation of 29 days. One patient had a recurrent stricture, and all patients responded to pneumatic dilation. Conclusions: A two-layered HS anastomosis has an acceptable rate of stricture. These strictures are early and respond well to pneumatic dilation.
机译：背景：腹腔镜Roux-en-Y胃旁路手术（LRYGB）后，胃空肠吻合口（GJA）的吻合口狭窄相对常见。有三种不同的执行GJA的方式：圆形装订（CS），线性装订（LS）和手工缝制（HS）。 CS技术提供了最标准的直径，而LS和HS技术可以通过使用弹簧架校准吻合直径来标准化。但是，它们都会变得严格。这项研究检查了4年内手工缝制的GJA的狭窄率。方法：前瞻性维护的数据库用于回顾性评估我们减肥中心的患者预后。已对该数据库进行了狭窄评估。由一名外科医生在4年内进行了胃旁路手术。该技术在研究期间一直保持标准。这是两层HS吻合术，具有可吸收缝合线（2.0 VICRYL（R））的四种不同缝合线。纳入标准为原发性腹腔镜胃搭桥术。排除标准是对开放程序和组合程序的修订和转换。结果：从2010年到2013年，共有454个初级LRYGB。 14名患者的总体狭窄率为3.1％。每年的变化幅度从2013年的0％下降到2012年的4.2％。平均狭窄时间为57.5天，标准差为29天。一名患者复发性狭窄，所有患者均对气管扩张反应。结论：两层HS吻合术的狭窄率可以接受。这些狭窄是早期的，并且对气动扩张反应良好。

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