COMPLICATIONS RELATED TO GASTRIC BYPASS PERFORMED WITH DIFFERENT GASTROJEJUNAL DIAMETERS

ABSTRACT Background: Among the options for surgical treatment of obesity, the most widely used has been the Roux-en-Y gastric bypass. The gastrojejunal anastomosis can be accomplished in two ways: handsewn or using circular and linear stapled. The complications can be divided in early and late. Aim: To compare the incidence of early complications related with the handsewn gastrojejunal anastomosis in gastric bypass using Fouchet catheter with different diameters. Method: The records of 732 consecutive patients who had undergone the bypass were retrospectively analyzed and divided in two groups, group 1 with 12 mm anastomosis (n=374), and group 2 with 15 mm (n=358). Results: The groups showed anastomotic stenosis with rates of 11% and 3.1% respectively, with p=0.05. Other variables related to the anastomosis were also analyzed, but without statistical significance (p>0.05). Conclusion: The diameter of the anastomosis of 15 mm was related with lower incidence of stenosis. It was found that these patients had major bleeding postoperatively and lower surgical site infection, and in none was observed presence of anastomotic leak.摘要 背景：在肥胖症外科治疗的各类术式中，应用最为广泛的当属Roux-en-Y胃旁路术。胃空肠吻合可通过两种方式完成：手工缝合，或采用圆形与线性吻合器进行吻合。术后并发症可分为早期并发症与晚期并发症。 研究目的：对比采用不同直径Fouchet导管（Fouchet catheter）实施胃旁路术时，手工缝合胃空肠吻合相关早期并发症的发生率。 方法：对732例连续接受胃旁路手术的患者病历资料进行回顾性分析，将其分为两组：第1组采用12 mm吻合口径（n=374），第2组采用15 mm吻合口径（n=358）。 结果：两组患者的吻合口狭窄发生率分别为11%与3.1%，组间差异具有统计学意义（p=0.05）。本研究同时分析了其他与吻合口相关的变量，但均未获得统计学显著性差异（p>0.05）。 结论：采用15 mm吻合口径可降低吻合口狭窄的发生率。此外，本研究发现该组患者术后大出血发生率更高，手术部位感染率更低，且未观察到吻合口漏病例。