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首页> 外文期刊>Surgical Endoscopy >Three-dimensional stomach analysis with computed tomography after laparoscopic sleeve gastrectomy: sleeve dilation and thoracic migration.
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Three-dimensional stomach analysis with computed tomography after laparoscopic sleeve gastrectomy: sleeve dilation and thoracic migration.

机译：腹腔镜套管胃切除术后用计算机断层扫描进行三维胃分析：套管扩张和胸廓移行。

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BACKGROUND: Laparoscopic sleeve gastrectomy (LSG) is frequently performed as a definitive bariatric procedure today. Quantitative data on the detailed anatomy of the stomach after LSG are yet sparse. METHODS: Thirty-two multislice computed tomography (MSCT) data sets acquired in 27 LSG patients (22 female, 5 male) with a dedicated examination protocol and post-processing were evaluated for gastric volume, stomach length, sleeve length, antrum length, staple line length, and maximum cross-sectional sleeve area. Obtained parameters were compared to time after surgery, weight loss, and the occurrence of postsurgical regurgitation. RESULTS: Mean gastric volume was 186.5+/-88.4 ml. Gastric volume correlated significantly with the time interval after surgery. Sleeve sizes of 105.3+/-30.2 ml during early follow-up confirmed correct primary sizing of the sleeve, whereas marked dilation to 196.8+/-84.3 ml was found in patients with a follow-up of 6 months and longer (p=0.038). Sleeve area and staple line length were also positively correlated with time after surgery. No correlation was found between gastric volume and excess weight loss. In ten patients an intrathoracic migration of the staple line could be noted, with four of these patients developing persistent regurgitation after LSG. Regurgitation was present in only 2 of 17 patients without sleeve herniation. CONCLUSION: Multislice computed tomography allows for a comprehensive and quantitative evaluation of the anatomy after LSG and thus provides new insights in the process of sleeve dilation. Intrathoracic migration of the staple line could be identified as a possible cause of persistent regurgitation.
机译：背景：腹腔镜袖胃切除术（LSG）如今已作为确定的减肥手术进行。 LSG术后胃的详细解剖结构的定量数据仍然很少。方法：对27例LSG患者（22例女性，5例男性）采用专门检查方案并进行后处理获得的32层计算机断层扫描（MSCT）数据集，评估其胃体积，胃长，袖长，窦长，钉书钉线长和最大横截面套筒面积。将获得的参数与术后时间，体重减轻和术后反流发生率进行比较。结果：平均胃体积为186.5 +/- 88.4 ml。胃容积与术后时间间隔显着相关。在早期随访期间，套管尺寸为105.3 +/- 30.2 ml，证实了正确的初级套管尺寸，而在随访6个月或更长时间的患者中，发现套管扩张至196.8 +/- 84.3 ml（p = 0.038） ）。袖子面积和吻合线长度也与术后时间呈正相关。在胃容量和体重减轻之间未发现相关性。在十名患者中，可以注意到钉书钉行胸腔内移行，其中四名患者在LSG后出现持续性反流。 17例无袖疝的患者中仅有2例存在反流。结论：多层计算机断层扫描可以对LSG术后的解剖结构进行全面，定量的评估，从而为套管扩张的过程提供新的见解。可以确定主食管胸腔内迁移是持续性反流的可能原因。

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