[Laparoscopic sleeve gastrectomy: technique and preliminary results].

Chirurgia italiana Pub Date : 2009-03-01
Daniele Capizzi, Sergio Boschi, Patrizio Patrizi, Luciano Fogli, Rossana Berta, Francesco Domenico Capizzi
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Abstract

According to the WHO about 300 million people in the world are affected by obesity with an increasing trend. The aim of the present study was to assess our preliminary results with sleeve gastrectomy. Over the period from June 2006 to March 2008, 25 laparoscopic sleeve gastrectomy were performed at our Department of Surgery for morbid obesity by the same surgeon. The operation consists in resection of approximately three quarters of the stomach with the creation of a long slender gastric tube, dividing the stomach vertically in two parts and removing all the left side with the greater curvature and gastric fundus. The mean age of the patients was 38 +/- 9 years, and the mean BMI 48 +/- 3. The mean operative time was 110 minutes, and the mean hospital stay 6 days. Mean intraoperative bleeding was negligible (20 cc). In our study we observed just one case of gastric leakage from the staple line, treated by surgical drainage and by placement of an endoscopic stent. There were no cases of bleeding of the resection margin and no long-term stenosis; there was no mortality. The mean follow-up was 18 months. BMI showed a mean reduction of about 17 points. During postoperative visits all the patients reported marked reduction of hunger sensation, together with a sense of early satiety. On the basis of these preliminary results we can consider laparoscopic sleeve gastrectomy as a safe, functional and definitive procedure that constitutes a valid alternative in bariatric surgery, though it is as yet not completely standardised and requires a longer follow-up.

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腹腔镜袖式胃切除术:技术及初步结果。
根据世界卫生组织的数据,世界上约有3亿人受到肥胖的影响,并呈上升趋势。本研究的目的是评估袖式胃切除术的初步结果。在2006年6月至2008年3月期间,同一位外科医生在我科为病态肥胖患者实施了25例腹腔镜袖胃切除术。该手术包括切除约四分之三的胃,并建立一个细长的胃管,将胃垂直分为两部分,并切除左侧弯曲较大的胃和胃底。患者平均年龄38 +/- 9岁,平均BMI 48 +/- 3。平均手术时间110分钟,平均住院时间6天。平均术中出血可忽略不计(20cc)。在我们的研究中,我们只观察到一例胃从钉线漏出,通过手术引流和放置内镜支架治疗。无切除缘出血,无长期狭窄;没有死亡。平均随访时间为18个月。身体质量指数平均下降了17分。术后随访期间,所有患者均报告饥饿感明显减少,并伴有早期饱腹感。基于这些初步结果,我们可以认为腹腔镜袖胃切除术是一种安全、有效和确定的手术,是减肥手术的有效选择,尽管它还没有完全标准化,需要更长的随访时间。
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