Clinical efficacy of three-port laparoscopic sleeve gastrectomy for obesity
10.3760/cma.j.issn.1673-9752.2017.06.007
- VernacularTitle:三孔法腹腔镜胃袖状切除术治疗肥胖症的临床疗效
- Author:
Yang LIU
;
Huanmei LIU
;
Dan WEI
;
Zhongtao ZHANG
;
Hua MENG
- Keywords:
Obesity;
Sleeve gastrectomy;
Laparoscopy;
Three-port
- From:Chinese Journal of Digestive Surgery
2017;16(6):566-570
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the feasibility,safety and clinical efficacy of three-port laparoscopic sleeve gastrectomy (TLSG).Methods The retrospective cross-sectional study was conducted.The clinical data of 104 obese patients who were admitted to the Beijing Friendship Hospital of Capital Medical University between September 2016 and March 2017 were collected.TLSG was performed to all the 104 patients by the same surgical team.The surgical situations,conversion situations (port-site increased or conversion to open surgery),operation time,volume of intraoperative blood loss,surgery-related complications,duration of postoperative hospital stay and follow-up situations were observed.Patients were followed up by Wechat,telephone interview and inpatient examination once at month 3,6,9 and 12 postoperatively and once every year after 1 year postoperatively up to April 2017.Follow-up included weight-loss efficacy and postoperative long-term complications.Measurement data with normal distribution were represented as x±s or average (range).Results All the 104 patients underwent successful TLSG,without port-site increased or conversion to open surgery.Operation time and volume of intraoperative blood loss were (121±25)minutes and (9±6)mL,respectively.There was no severe intraoperative collateral damage.All the 104 patients with complications were cured by symptomatic treatment,including 1 with port-site infection,1 with peritoneal effusions causing secondary infection,3 with improper eating-induced acute delayed gastric emptying,6 with fat liquefaction around port-site and 9 with delay healing of port-site.There was no occurrence of severe complications,such as gastrointestinal bleeding,intra-abdominal bleeding and gastrostoma.Duration of postoperative hospital stay was (2.4±0.8)days.Eighty-two patients were followed up for 3 months (range,3-6 months),including 59 with 3-month follow-up,23 with 6-month follow-up and 22 with under 3-month follow-up.During the follow-up,there was no port-site hernia.Excess weight loss (EWL) was 37％± 11％ in 59 patients with 3-month follow-up and 45％± 13％ in 23 patients with 6-month follow-up.Of 59 patients with 3-month follow-up,14 patients with diabetes mellitus stopped taking antidiabetic drugs,10 of 14 patients had complete remission (CR) of hemoglobin Alc (HbAlc) and 4 of 14 patients had partial remission (PR) of HbAlc.Of 23 patients with 6-month follow-up,6 patients with diabetes mellitus had CR of HbAlc.Of 18 patients with obstructive sleep apnea hypopnea syndrome (OSAHS),4 had 3-month follow-up,including 3 with CR and 1 was improved to mild OSAHS.Other 14 patients were not evaluated due to inadequate follow-up time.Conclusion TLSG for obese patients with specific indications cannot increase operation time and risk,meanwhile,it can reduce port-site,with a good cosmetic effect.
