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首页> 外文期刊>Surgical Endoscopy >Endoscopic management of stomal stenosis after Roux-en-Y gastric bypass.
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Endoscopic management of stomal stenosis after Roux-en-Y gastric bypass.

机译：Roux-en-Y胃旁路手术后的内窥镜处理口狭窄。

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Background: In the United States, Roux-en-Y gastric bypass has evolved into the procedure of choice for clinically severe obesity. Stomal stenosis resulting in gastric outlet obstruction is a recognized complication. Endoscopic balloon dilation is often used to treat this condition. To evaluate the safety and efficacy of endoscopic management of stomal stenosis we evaluated our treatment methods and outcomes. Methods: The records of all patients undergoing Roux-en-Y gastric bypass from 1 July 2000 to 30 June 2002 were studied. Stenosis was defined as signs and symptoms of obstruction with inability to cannulate the gastrojejunostomy using an 8.5-mm diagnostic endoscope. Charts were reviewed and demographic data, operative course, symptoms, and outcomes were recorded. Results: A total of 562 patients underwent Roux-en-Y gastric bypass for obesity during the study period. Of these, 38 patients underwent endoscopic balloon dilation for stomal stenosis, for a stenosis rate of 6.8%. The average time from surgery to initial dilation was 7.7 weeks (range 3 to 24). The average number of dilations required was 2.1 (range one to six). The mean initial balloon size was 13 mm and the mean final balloon size was 16 mm. Two patients failed endoscopic dilation and proceeded to surgery, including one patient who developed pneumomediastinum and pneumothorax after dilation. All patients were relieved of their gastric outlet obstruction. The success rate for endoscopic balloon dilation was 95% with a 3% complication rate. Conclusions: In our experience, the rate of gastrojejunostomy stenosis following Roux-en-Y gastric bypass is 6.8%. Endoscopic balloon dilation is a safe and effective therapy for stomal stenosis with a high success rate. It should be considered an appropriate intervention with a low risk for reoperation.
机译：背景：在美国，Roux-en-Y胃搭桥术已发展成为临床上严重肥胖症的首选治疗方法。导致胃出口阻塞的气管狭窄是公认的并发症。内窥镜球囊扩张术通常用于治疗这种情况。为了评估内窥镜处理口狭窄的安全性和有效性，我们评估了我们的治疗方法和结果。方法：研究2000年7月1日至2002年6月30日所有接受Roux-en-Y胃搭桥术的患者的记录。狭窄定义为使用8.5 mm诊断内窥镜无法插管胃空肠吻合术的阻塞的体征和症状。检查图表并记录人口统计学数据，手术过程，症状和结局。结果：在研究期间，共有562名患者因肥胖而接受了Roux-en-Y胃旁路手术。其中38例因气孔狭窄而进行了内镜球囊扩张术，狭窄率为6.8％。从手术到初次扩张的平均时间为7.7周（范围3到24）。所需的平均扩张次数为2.1（范围为1到6）。平均初始球囊尺寸为13 mm，平均最终球囊尺寸为16 mm。两名患者在内镜下扩张失败，并进行了手术，其中一名患者在扩张后出现了肺纵隔和气胸。所有患者均解除了胃出口梗阻。内窥镜球囊扩张术的成功率为95％，并发症率为3％。结论：根据我们的经验，Roux-en-Y胃旁路术后胃空肠吻合口狭窄率为6.8％。内窥镜球囊扩张术是治疗口狭窄的一种安全有效的方法，成功率很高。应该将其视为再手术风险较低的适当干预措施。

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