对称3孔法腹腔镜袖状胃切除术的临床应用价值

Clinical application value of symmetrical three-hole laparoscopic sleeve gastrectomy

    摘要
  • 摘要: 目的:探讨对称3孔法腹腔镜袖状胃切除术(LSG)的临床应用价值。
    方法:采用回顾性描述性研究方法。收集2017年4月至2018年12月郑州大学附属郑州中心医院收治的232例肥胖症患者的临床资料；男40例，女性192例；年龄为(32±8)岁，年龄范围为17～63岁。232例患者均行对称3孔法LSG。观察指标：(1)手术及术后情况。(2)并发症情况。(3)随访情况。采用电话和微信方式进行随访，了解患者术后3个月的手术切口美容满意情况。随访时间截至2019年3月。正态分布的计量资料以Mean±SD表示。计数资料以绝对数或百分比表示。
    结果:(1)手术及术后情况：232例患者中，230例成功施行对称3孔法LSG，无中转开腹。2例患者因脾脏出血，术中增加1个穿刺孔协助牵拉大网膜止血，改进手术流程后未再次发生脾脏出血。232例患者手术时间为(115±7)min，术中出血量为(10±5)mL，术后住院时间为(3.0±0.8)d。(2)并发症情况：232例患者中，10例术后发生脐部切口脂肪液化，经多次换药后痊愈。232例患者无消化道出血、腹腔出血、胃瘘等严重并发症发生。(3)随访情况：232例患者中，230例成功施行对称3孔法LSG的患者术后3个月均完成随访。230例患者中，手术切口美容满意情况不满意3例，满意12例，非常满意215例，满意率为98.70%(227/230)。
    结论:对称3孔法LSG安全、可行，手术切口美容效果好。

     

    Abstract: Objective:To investigate the clinical application value of symmet rical threehole laparoscopic sleeve gastrectomy (LSG).
    Methods:The retrospective and descriptive study was conducted. The clinical data of 232 patients with obesity who were admitted to Zhengzhou Central Hospital Affiliated to Zhengzhou University from April 2017 to December 2018 were collected. There were 40 males and 192 females, aged (32±8)years, with a range of 17-63 years. All the 232 patients underwent symmetrical threehole LSG. Observation indicators: (1) surgical and postoperative conditions; (2) complications; (3) follow-up. Followup was conducted by telephone interview and WeChat to collect the patient satisfaction with cosmetic effects of wounds at 3 months after surgery up to March 2019. Measurement data with normal distribution were expressed as Mean±SD. Count data were expressed as absolute numbers or percentages.
    Results:(1) Surgical and postoperative conditions: of the 232 patients, 230 underwent symmetrical threehole LSG successfully, without conversion to open surgery. Two patients had one puncture hole added due to spleen bleeding to help pull the omentum to stop bleeding, and no spleen hemorrhage recurred after improving the surgical procedure. Of the 232 patients, the operation time, volume of intraoperative blood loss, and duration of postoperative hospital stay were (115±7)minutes, (10±5)mL, and (3.0±0.8)days. (2) Complications: of the 232 patients, 10 had postoperative complications of fat liquefaction in the umbilical incision, and were cured after repeated dressing changes. All patients had no serious complications such as gastrointestinal bleeding, abdominal bleeding, or gastric fistula. (3) Followup: of the 232 patients, 230 undergoing successful symmetrical threehole LSG were followed up for 3 months. Of the 230 patients, 3 were dissatisfied with the cosmetic effects of wounds, 12 were satisfied, and 215 were very satisfied. The satisfaction rate was 98.70%(227/230).
    Conclusion:Symmetrical threehole LSG is safe and feasible, with a good cosmetic effects of wounds.

     

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