网膜复位固定术对减少腹腔镜袖状胃切除术后胃肠道症状的临床分析  

Clinical analysis of omentopexy for reducing gastrointestinal symptoms after laparoscopic sleeve gastrectomy

作　　者：李士军 解晶晶 屈兵 刘家盛[1] Li Shijun;Xie Jingjing;Qu Bing;Liu Jiasheng(Department of Gastrointestinal Surgery,Renmin Hospital of Wuhan University,Wuhan 430200,Hubei,China;Mental Health Center,Renmin Hospital of Wuhan University,Wuhan 430200,Hubei,China)

机构地区：[1]武汉大学人民医院胃肠外科,湖北武汉430200 [2]武汉大学人民医院精神卫生中心,湖北武汉430200

出　　处：《中国现代手术学杂志》2023年第2期81-85,共5页Chinese Journal of Modern Operative Surgery

摘　　要：目的探讨网膜复位固定术对减少腹腔镜袖状胃切除(laparoscopic sleeve gastrectomy,LSG)术后相关胃肠道症状的临床效果。方法选择2019年1月至2021年1月在武汉大学人民医院胃肠外科拟行LSG手术患者200例,随机分为试验组和对照组,每组100例,分别行LSG加网膜复位固定术和单纯LSG术。分析比较两组患者的手术时间、住院时间、术后恶心、呕吐、胃食管反流发生率、PPI及止吐药使用情况等相关指标。结果最终试验组95例,对照组93例患者完成术后1年的随访。两组手术时间及住院时间比较,差异均无统计学意义(P>0.05)。所有患者术后均未发生残胃漏与出血,大多数患者术后48 h恶心症状消失。术后1月试验组持续恶心、呕吐的发生率及止吐药使用率,术后1年胃食管反流发生率、长时间(>3个月)PPI使用率均低于对照组,差异均有统计学意义(P<0.05)。结论网膜复位固定术可减少腹腔镜袖状胃切除术后恶心、呕吐、胃食管反流等胃肠道症状,临床安全有效。Objective To investigate the clinical effect of omentopexy on reducing gastrointestinal symptoms after laparoscopic sleeve gastrectomy(LSG).Methods From January 2019 to January 2021,a total of 200 patients who scheduled to perform LSG in the Department of Gastrointestinal Surgery of Renmin Hospital of Wuhan University were randomly divided into experimental group and control group,with 100 patients in each group,and received LSG plus omentopexy and simple LSG respectively.The operation time,hospital stays,the incidence of postoperative nausea,vomiting,gastroesophageal reflux and administration rate of proton pump inhibitor(PPI)and antiemetic drugs were compared between the two groups.Results 95 cases accomplished one-year follow-up in the experimental group and 93 cases was in the control group.There was no significant difference in operation time and hospital stays between the two groups(P>0.05).No residual gastric leakage and hemorrhage occurred in all cases,and nausea symptoms were disappeared within 48 hours after surgery in most patients.The incidence of persistent nausea and vomiting one month after the operation,administration rate of antiemetics,gastroesophageal reflux rate one year after operation and long-term administration rate of PPI(>3 months)were lower in the experimental group than those in the control group,and all differences were statistically significant(P<0.05).Conclusion Omentopexy can reduce gastrointestinal symptoms such as nausea,vomiting and gastroesophageal reflux after LSG,and which is safe and effective in clinical practice.

关 键 词：腹腔镜袖状胃切除术 网膜复位固定术 胃食管反流 

分 类 号：R656.61[医药卫生—外科学]