腹腔镜袖状胃切除术中大网膜复位对术后恶心呕吐影响

Effect of repositioning of the large omentum in laparoscopic sleeve gastrectomy for postoperative nausea and vomiting

摘要

目的 探讨腹腔镜袖状胃切除术(laparoscopic sleeve gastrectomy, LSG)中大网膜复位对减少术后恶心呕吐(postoperative nausea and vomiting, PONV)的影响。方法 采取回顾性队列研究的方法，收集 2023 年 1 月至 2024 年 1 月在山东大学齐鲁第二医院胃肠外科接受 LSG 的 62 例肥胖症患者围手术期临床资料。其中，30 例患者行 LSG 大网膜复位(大网膜复位组)，32 例患者仅进行缝合加固胃切缘(对照组)。收集两组患者的术前基线资料、围手术期资料，比较患者术后 PONV 的频率评分、视觉模拟评分(visual analogue scale, VAS)、语言描述评分(verbal descriptive scale, VDS)。结果 两组患者的手术时间、加固缝合时间、术中出血量差异无统计学意义(P>0.05)。在术后 0~12、12~24 及 24~72 h 内，大网膜复位组患者的 PONV 的频数评分、VAS 评分、VDS 评分都优于对照组(P<0.05)。结论 LSG 中大网膜复位可降低患者 PONV 的发生率及严重程度。

Abstract

Objective To explore the impact of greater omentum repositioning after laparoscopic sleeve gastrectomy (LSG) on reducing postoperative nausea and vomiting (PONV). Methods A retrospective cohort study was conducted to collect the perioperative clinical data of 62 obese patients who underwent LSG in the Department of Gastrointestinal Surgery, The Second Qilu Hospital of Shandong University from January 2023 to January 2024. Among them, 30 patients underwent greater omentum repositioning after LSG (reduction group), and 32 patients only had the gastric incision sutured and reinforced (control group). The preoperative baseline data and perioperative data of the patients were collected. The frequency scores of PONV, visual analogue scale (VAS) scores, and verbal descriptive scale (VDS) scores between the two groups of patients postoperatively were compared. Results There was no statistically significant differences in surgical duration, reinforcement suture time, and intraoperative blood loss between the two groups (P>0.05). Within 0-12 hours, 12-24 hours, and 24-72 hours after surgery, the frequency score, VAS score, and VDS score of PONV in the reduction group were higher than those in the control group (P > 0.05). Conclusion Reduction of the greater omentum during LSG may decrease the occurrence and intensity of PONV in patients.

关键词

腹腔镜 / 袖状胃切除术 / 术后恶心呕吐 / 肥胖症 / 大网膜复位

Key words

Laparoscopic / Sleeve gastrectomy / Postoperative nausea and vomiting / Obesity / Repositioning of the large omentum

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