难治性胃痉挛的手术治疗:哥伦比亚首例胃旁路术与幽门成形术对比病例系列

IF 0.4 4区 医学 Q4 SURGERY Indian Journal of Surgery Pub Date : 2024-03-16 DOI:10.1007/s12262-024-04025-w
Carlos Lopera, Jean Pierre Vergnaud, Raúl Suarez, Alexandra Galeano-Buelvas, Fabriccio J. Visconti-Lopez, Ivan David Lozada-Martinez, Mauricio Pedraza, Luis Felipe Cabrera-Vargas
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引用次数: 0

摘要

胃瘫是一种常见的上消化道运动障碍。手术治疗是一项挑战,尤其是在缺乏专有数据或手术治疗经验的地区。本研究旨在比较接受胃旁路术和幽门成形术治疗难治性胃瘫患者的手术效果,这在哥伦比亚尚属首次。2018年1月至2020年12月期间,哥伦比亚一家三级转诊中心对16名接受幽门成形术或腹腔镜胃旁路术的难治性胃瘫患者进行了纵向研究。10名患者(62.5%)接受了胃旁路手术,其中93.8%为女性。幽门成形术的手术时间明显更短(P = 0.001),症状缓解时间也明显更短(头24小时内50%对30%,15天内100%对70%)。术前和术后的平均体重指数(BMI)分别为29.7(21.3-33.4)和23.1(20.9-25.4)。除了胃旁路手术组的体重指数较高外(P = 0.01),两组患者的所有分析特征均相似。胃旁路术使基线 BMI 值降低了约 20%,而幽门成形术则降低了 5%。这项研究发现,这两种技术对难治性胃痉挛的手术治疗都是可行和安全的。对于肥胖患者来说,胃旁路术可能是首选,因为它能减轻更多的体重,从而影响更多的治疗效果。
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Surgical Management for Refractory Gastroparesis: First Comparative Case Series between Gastric Bypass and Pyloroplasty in Colombia

Gastroparesis is a common motor disorder of the upper gastrointestinal tract. Surgical management presents a challenge, particularly in regions lacking proprietary data or experience with surgical approaches to this condition. This study aimed to compare surgical outcomes of patients undergoing gastric bypass vs. pyloroplasty for refractory gastroparesis, for the first time in Colombia. A longitudinal study was conducted on 16 patients with refractory gastroparesis undergoing pyloroplasty or laparoscopic gastric bypass at a tertiary referral center in Colombia between January 2018 and December 2020. Ten (62.5%) patients underwent gastric bypass, and 93.8% were women. Surgical time was significantly shorter with pyloroplasty (p = 0.001), as well as time to symptom resolution (50% vs. 30% within the first 24 h, and 100% vs. 70% at 15 days). The preoperative and postoperative mean body mass index (BMI) was 29.7 (21.3—33.4) and 23.1 (20.9—25.4), respectively. Both groups were similar in all analyzed characteristics except for a higher BMI in the gastric bypass group (p = 0.01). Gastric bypass resulted in a reduction of approximately 20% of the baseline BMI value, compared to 5% with pyloroplasty. This study found that both techniques were feasible and safe for surgical treatment of refractory gastroparesis. Gastric bypass may be preferred for obese patients due to greater weight loss, which could impact additional outcomes.

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来源期刊
CiteScore
0.60
自引率
25.00%
发文量
412
审稿时长
6-12 weeks
期刊介绍: The Indian Journal of Surgery is the official publication of the Association of Surgeons of India that considers for publication articles in all fields of surgery. Issues are published bimonthly in the months of February, April, June, August, October and December. The journal publishes Original article, Point of technique, Review article, Case report, Letter to editor, Teachers and surgeons from the past - A short (up to 500 words) bio sketch of a revered teacher or surgeon whom you hold in esteem and Images in surgery, surgical pathology, and surgical radiology. A trusted resource for peer-reviewed coverage of all types of surgery Provides a forum for surgeons in India and abroad to exchange ideas and advance the art of surgery The official publication of the Association of Surgeons of India 92% of authors who answered a survey reported that they would definitely publish or probably publish in the journal again The Indian Journal of Surgery offers peer-reviewed coverage of all types of surgery. The Journal publishes Original articles, Points of technique, Review articles, Case reports, Letters, Images and brief biographies of influential teachers and surgeons. The Journal spans General Surgery, Pediatric Surgery, Neurosurgery, Plastic Surgery, Cardiothoracic Surgery, Vascular Surgery, Rural Surgery, Orthopedic Surgery, Urology, Surgical Oncology, Radiology, Anaesthesia, Trauma Services, Minimal Access Surgery, Endocrine Surgery, GI Surgery, ENT, Colorectal Surgery, surgical practice and research. The Journal provides a forum for surgeons from India and abroad to exchange ideas, to propagate the advancement of science and the art of surgery and to promote friendship among surgeons in India and abroad. This has been a trusted platform for surgons in communicating up-to-date scientific informeation to the community.
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