Trans-mesocolic Pull-Through Maneuver: A Safe Operative Technique for Short and Thick Mesentery in Severe Obesity
Küçük Resim Yok
Tarih
2022
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Springer India
Erişim Hakkı
info:eu-repo/semantics/closedAccess
Özet
Although right gastric artery ligation is efficient to enhance a lower-tension anastomosis, still in severe intra-abdominal adiposity, antecolic approach may not provide sufficient length for a safe duodenoenterostomy anastomosis. Combining right gastric artery ligation with trans-mesocolic pull-through overcomes the thick mass of the transverse colon to achieve low-tension anastomosis. Trans-mesocolic pull-through operative technique was performed in duodenal switch, duodenojejunal bypass, and single anastomosis duodenoileal bypass with sleeve gastrectomy procedures. Demographic data, body mass index, operation time, perioperative, and postoperative complications were analyzed. A total of 70 patients were included in the study between January 2013 to December 2016. The male/female ratio was 0.4 (male/female: 20/50). The mean age was 41.1 years (age:18-67). A total of 28 patients had single anastomosis duodenoileal bypass with sleeve gastrectomy, 34 had duodenal switch, and 8 had duodenojejunal bypass operations. The mean BMI was 51.9 kg/m(2) (35-64), mean duration of surgery was 232.9 min (134-346), and mean hospital stay was 5.2 days (3-9). No early or late postoperative mortality was observed. The overall complication rate related with operative technique was 4.3% (n:3) including post-pyloric duodenal necrosis, duodenal stump fistula, and intra-abdominal abscess. A total of 67 patients were discharged uneventfully with a follow-up of mean of 75.9 (52-96) months in term. The current paper put into a modified approach with right gastric artery ligation and pull-through of the gastric sleeve and may be a safe technique in short and thick mesentery patients for a low-tension anastomosis.
Açıklama
Anahtar Kelimeler
Metabolic Surgery, Duodenal Switch, Visceral Obesity, Thick Mesentery, Gastric Bypass
Kaynak
Indian Journal Of Surgery
WoS Q Değeri
Q4
Scopus Q Değeri
N/A
Cilt
84
Sayı
6
