Survey on laparoscopic sleeve gastrectomy (LSG) at the Fourth International Consensus Summit on Sleeve Gastrectomy
Survey on laparoscopic sleeve gastrectomy (LSG) at the Fourth International Consensus Summit on Sleeve Gastrectomy
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DOI：
10.1007/s11695-013-1040-x
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发表时间：
2013-12-01
期刊：
影响因子：
2.9
通讯作者：
Crosby, Ross D.
中科院分区：
文献类型：
--
作者：
Gagner, Michel;Deitel, Mervyn;Crosby, Ross D.
一次总付办法越来越多地得到执行。在2012年12月纽约第四届LSG国际共识峰会期间，130名有LSG经验的外科医生填写了一份在线问卷（SurveyMonkeyA（R））。该调查直接提交给统计学家，130名外科医生进行了354.9 +/- SD 453次LSG/外科医生（中位数175），总共46，133次LSG。LSG已进行了4.9 +/- 2.7年（范围1-10）。在46，133例LSG中，0.2 +/-1.0%（中位数0，范围0- 10%）转为开放手术。93.1 +/-14.8%的患者计划将LSG作为唯一手术; 3.0 +/-6.3%的患者需要第二阶段。在130名外科医生中，40名（32%）使用36 F探条，这是最常见的（范围32- 50 F）。79%的缝钉线得到加强;其中，57%使用了支撑物，43%使用了缝合线。第1年的平均%EWL为59.3%;第2年为59.0%;第3年为54.7%;第4年为52.3%;第5年为52.4%;第6年为50.6%。如果有必要进行第二阶段手术，首选：RYGB 46%，十二指肠转位24%，再套管20%，单吻合十二指肠回肠旁路3%，套管折叠3%，小胃旁路3%，不可调节带2%，侧侧空肠回肠吻合1%。并发症为：高漏1.1%，出血1.8%，下套管狭窄0.9%。术后胃食管反流发生率为7.9 +/-8.2%，但可变（0- 30%）。死亡率为0.33 +/-1.6%，即152例死亡。89%的人订购了多种维生素（包括维生素D、钙和铁），72%的人订购了B-12。PPI订购1个月29%，3个月29%，其他1-12个月，视情况而定。LSG相对安全。需要进一步的长期监测。
LSG has been increasingly performed. Long-term follow-up is necessary.During the Fourth International Consensus Summit on LSG in New York Dec. 2012, an online questionnaire (SurveyMonkeyA (R)) was filled out by 130 surgeons experienced in LSG. The survey was submitted directly to the statisticians.The 130 surgeons performed 354.9 +/- SD 453 LSGs/surgeon (median 175), for a total of 46,133 LSGs. The LSGs had been performed over 4.9 +/- 2.7 year (range 1-10). Of the 46,133 LSGs, 0.2 +/- 1.0 % (median 0, range 0-10 %) were converted to an open operation. LSG was intended as the sole operation in 93.1 +/- 14.8 %; in 3.0 +/- 6.3 %, a second stage became necessary. Of the 130 surgeons, 40 (32 %) use a 36F bougie, which was most common (range 32-50F). Staple-line is reinforced by 79 %; of these, 57 % use a buttress and 43 % over-sew. Mean %EWL at year 1 was 59.3 %; year 2, 59.0 %; year 3, 54.7 %; year 4, 52.3 %; year 5, 52.4 %; and year 6, 50.6 %. If a second-stage operation becomes necessary, preference was: RYGB 46 %, duodenal switch 24 %, re-sleeve 20 %, single-anastomosis duodenoileal bypass 3 %, sleeve plication 3 %, minigastric bypass 3 %, non-adjustable band 2 %, and side-to-side jejunoileal anastomosis 1 %. Complications were: high leak 1.1 %, hemorrhage 1.8 %, and stenosis at lower sleeve 0.9 %. Postoperative gastroesophageal reflux occurred in 7.9 +/- 8.2 % but was variable (0-30 %). Mortality was 0.33 +/- 1.6 %, which translates to 152 deaths. Eighty-nine percent order multivitamins (including vitamin D, calcium, and iron) and 72 % order B-12. A PPI is ordered by 29 % for 1 month, 29 % for 3 months, and others for 1-12 months depending on the case.LSG was relatively safe. Further long-term surveillance is necessary.