单孔腹腔镜胃袖状切除术疗效的初步研究  

Effect of single-incision laparoscopic sleeve gastrectomy for obesity

作　　者：杨珵璨 于洋 王文越[1] 刘超凡 戴谦诚[1] 王兵[1] Yang Chengcan;Yu Yang;Wang Wenyue;Liu Chaofan;Dai Qiancheng;Wang Bing(Department of General Surgery,Shanghai Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200011,China)

机构地区：[1]上海交通大学医学院附属第九人民医院普外一科,上海200011

出　　处：《腹部外科》2022年第5期344-349,共6页Journal of Abdominal Surgery

基　　金：国家自然科学基金(82070917);肥胖合并阻塞性睡眠呼吸暂停患者生物样本库(YKBB201914)。

摘　　要：目的初步研究单孔腹腔镜胃袖状切除术(single-incision laparoscopic sleeve gastrectomy,SILSG)在轻中度肥胖病人的治疗结果。方法回顾性收集上海交通大学医学院附属第九人民医院2019年8月至2021年2月行腹腔镜胃袖状切除术的266例病人临床资料,纳入接受SILSG的轻中度肥胖病人20例(SILSG组)和接受传统三孔腹腔镜胃袖状切除术(three-port laparoscopic sleeve gastrectomy,TPLSG)的轻中度肥胖病人47例(TPLSG组)。对比两组病人术后住院时间、手术时间、术中出血量、手术相关并发症发生情况,以评估手术安全性;对比两组病人术后12个月的总体重减轻百分比、体质量指数、颈围、胸围、腰围和臀围的改变以及肥胖相关代谢疾病的改善情况,评估减重疗效;对比两种术式的术后疼痛评分和美观满意度。结果SILSG组的术后疼痛数字评分(NRS)优于TPLSG组[(1.5±0.3)分比(2.1±0.6)分,P<0.05],其美观满意比例也优于TPLSG组[90.0%比63.8%,P<0.05]。两组间的术后住院时间、术中出血量、手术时间、体质量指数减少和总体重减轻百分比比较,差异均无统计学意义(均P>0.05)。结论SILSG组对轻中度肥胖病人的减重效果、肥胖合并症改善与TPLSG组相比无明显差异;相同镇痛模式下,SILSG组病人术后疼痛感轻,且对切口的美观满意度更高。Objective To evaluate the safety and short-term effect of single-incision laparoscopic gastrectomy for obesity.Methods A retrospective review was conducted for patients undergoing single-incision laparoscopic sleeve gastrectomy(SILSG)and three-port laparoscopic sleeve gastrectomy(TPLSG).Patient demographics,intraoperative parameters,and perioperative outcomes were recorded postoperative data were obtained from routine follow-ups.From August 2019 to February 2021,clinical data were reviewed for 266 obese patients with concurrent metabolic diseases undergoing laparoscopic sleeve gastrectomy.There were SILSG(n=20)and TPLSG(n=47).Results No inter-group differences existed in body mass index(BMI),age,gender,number/type of comorbidities,operative duration,intraoperative blood loss,morbidity,hospital stay,%TWL and improvement/resolution of comorbidities associated with obesity.There was not any conversion into open surgery.No major complications or mortalities occurred.Postoperative numerical rating scale(NRS)and ratio of aesthetic satisfaction were(1.5±0.3)vs.(2.1±0.6)and 90.0%vs.63.8% respectively.Conclusion The technique of SILSG offers the equivalent outcomes of weight loss,comorbidities of obesity and related complication as compared with TPLSG.And SILSG is both feasible and safe for selected patients.The major benefits are excellent cosmetics and minimal pain.

关 键 词：腹腔镜胃袖状切除术 肥胖症 单孔 

分 类 号：R615[医药卫生—外科学]