CAJ | 학술논문

目的探讨腹腔镜下袖套式胃大部切除和部分小肠切除术治疗重度肥胖症的手术方法、安全性和近期疗效.方法从2006年12月至2007年9月,为10例重度肥胖症患者进行了腹腔镜下袖套式胃大部切除和部分小肠切除术.手术包括3部分:(1)自大弯侧距幽门5～6 cm处起垂直向上至贲门左侧His角,用内镜下切割吻合器向上切除大弯侧胃,保留和形成宽约2～3 cm的小弯侧管状胃;(2)切除大网膜;(3)切除约1/3～2/5的小肠.结果本组10例腹腔镜下袖套式胃大部切除和部分小肠切除术全部完成,无1例需中转开腹手术.手术中位时间3.1 h,无术后并发症,术后平均住院7 d.10例患者术前平均体质量指数为36.1 ks/m2,术后1个月、3个月和6个月平均体质量指数分别减少了4.1 ks/m2、5.6 ks/m2和7.3 ks/m2,平均体重分别减轻11.7 kg、17.5 kg和22.0 kg.结论腹腔镜下袖套式胃大部切除和部分小肠切除术治疗重度肥胖症安全性高、近期疗效满意.
목적 탐토복강경하수투식위대부절제화부분소장절제술치료중도비반증적수술방법、안전성화근기료효.방법 종2006년12월지2007년9월,위10례중도비반증환자진행료복강경하수투식위대부절제화부분소장절제술.수술포괄3부분:(1)자대만측거유문5～6 cm처기수직향상지분문좌측His각,용내경하절할문합기향상절제대만측위,보류화형성관약2～3 cm적소만측관상위;(2)절제대망막;(3)절제약1/3～2/5적소장.결과 본조10례복강경하수투식위대부절제화부분소장절제술전부완성,무1례수중전개복수술.수술중위시간3.1 h,무술후병발증,술후평균주원7 d.10례환자술전평균체질량지수위36.1 ks/m2,술후1개월、3개월화6개월평균체질량지수분별감소료4.1 ks/m2、5.6 ks/m2화7.3 ks/m2,평균체중분별감경11.7 kg、17.5 kg화22.0 kg.결론 복강경하수투식위대부절제화부분소장절제술치료중도비반증안전성고、근기료효만의.
Objective To explore the short-term result and safety of laparoscopie sleeve gastrectomy and partial enterectomy for the treatment of morbid obesity.Methods Ten patients underwent laparoscopic sleeve gastrectomy,omentectomy,and partial enterectomy as a treatment option for weight reduction between December 2006 and September 2007.The procedure included 70%-75%vertical (sleeve)gastrectomy,omentectomy,and 1/3 to 2/5 enterectomy preserving proximal jejunum and most of the ileum. Results Laparoscopy was completed in all patients,no conversion to open surgery.The operation time averaged at 3.1 hours(range 2.5-3.5 hours),and there was no postoperative complications.The median postoperative hospital stay was 7 days(range 6-8 days).Mean preoperative BMI was 36.1(32.0-40.5)kg/m2.Mean decrease in BMI was 4.1(3.0-4.7)ks/m2,5.6(3.2-9.0)kg/m2,and 7.3(3.2-10.7)kg/m2 respectively,and mean weight loss at postoperative 1,3,and 6 months was 11.7(7-15)kg,17.5(8-25)kg,and 22.0(8-32)kg respectively.Conclusion Laparoscopic sleeve gastrectomy with omentectomy and partial enterectomy is an effective and safe surgical option for the treatment of morbid obesity.