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在Roux-en-Y胃绕道术后转换为十二指肠切换是否安全? 短期结果审查审查
William Law1, Emily Ortega-Goddard2, Marcoandrea Giorgi1
1Department of Surgery, Brown University/The Miriam Hospital, 164 Summit Avenue, Providence, RI, 02906, USA.
Surgical endoscopy
|October 28, 2024
概括
修改Roux-en-Y胃绕道 (RYGB) 比转换为十二指肠切换 (DS) 更安全,以恢复体重. 十二指甲切换 (DS) 转换在短期结果中显示出更高的并发症率,突出显示了需要仔细选择和咨询患者的需要.
科学领域:
- 腹部外科 腹部外科
- 外科手术的结果
- 代谢手术 代谢手术
背景情况:
- 重量恢复影响约20%的Roux-en-Y胃旁路术 (RYGB) 后患者.
- 恢复体重的外科选择包括RYGB修订或转换为十二指肠开关 (DS).
研究的目的:
- 为了比较RYGB修订的安全性和有效性与重量恢复的DS转换.
- 使用代谢和腹部外科认证和质量改善计划 (MBSAQIP) 数据库进行分析.
主要方法:
- 2020年MBSAQIP参与者使用数据文件 (PUF) 的分析.
- 与1255名接受RYGB修订的患者进行比较,其中166名患者从RYGB转换为DS.
- 评估患者特征,手术前的BMI,手术室时间和30天后的并发症.
主要成果:
- DS组的平均BMI高 (47.5比42.7) 和更长的手术时间 (209.1比133.4分钟).
- 转换DS与明显更高的整体并发症率有关 (22.3%对5.58%).
- 具体的并发症,包括再入院,再手术,静脉动脉突发症,重症监护室入院,道泄漏,SSO和死亡在DS组中更高.
结论:
- 与RYGB修改相比,从RYGB转换为DS与短期术后并发症增加有关.
- 由于其复杂性,DS转换需要经验丰富的外科医生,仔细的患者选择和彻底的风险咨询.
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