Pneumatic dilation for functional helix stenosis after sleeve gastrectomy: long-term follow-up (with videos)
| Autor: | Gianfranco Donatelli, Renaud Chiche, Jean-Marc Catheline, Jean-Pierre Marmuse, I. Dagher, Guillame Pourcher, Bertrand-Marie Vergeau, Bruno Meduri, Jean-Loup Dumont, Hadrien Tranchart, Stavros Dritsas, Thierry Tuszynski |
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| Přispěvatelé: | Donatelli, G, Dumont, Jl, Pourcher, G, Tranchart, H, Tuszynski, T, Dagher, I, Catheline, Jm, Chiche, R, Marmuse, Jp, Dritsas, S, Vergeau, Bm, Meduri, B. |
| Rok vydání: | 2017 |
| Předmět: |
Adult
Male Torsion Abnormality medicine.medical_specialty Sleeve gastrectomy Long term follow up medicine.medical_treatment Stomach Diseases Bariatric Surgery 030209 endocrinology & metabolism Constriction Pathologic Young Adult 03 medical and health sciences Postoperative Complications 0302 clinical medicine Gastrectomy medicine Humans Retrospective Studies Pneumatic dilation business.industry Stomach Anastomosis Surgical Middle Aged medicine.disease Dilatation Dysphagia Obesity Morbid Surgery Stenosis Treatment Outcome medicine.anatomical_structure Retreatment Dilation (morphology) Female Laparoscopy Stents 030211 gastroenterology & hepatology medicine.symptom Pouch Deglutition Disorders business Follow-Up Studies |
| Zdroj: | Surgery for Obesity and Related Diseases. 13:943-950 |
| ISSN: | 1550-7289 |
| Popis: | Background A large number of patients who undergo laparoscopic sleeve gastrectomy present with surgical complications. Stenosis, in particular, occurs in .7%–4% of cases. Objectives To report our experience, results, and long-term follow-up after pneumatic dilation of late functional helix stenosis after laparoscopic sleeve gastrectomy. Setting Multicenter study led by an endoscopic tertiary referral center. Methods Thirty-five patients were dilated initially at 30 mm. Thirteen out of 35 patients underwent a second dilation up to 35 mm. Only 8 patients underwent a third pneumatic dilation up to 40 mm. The stricture was localized in the mid-body of the sleeve in 32 patients overall; 3 had narrowing adjacent to the cardia. Eleven twists formed an acute angle between the 2 segments of the stomach, whereas 24 angles were obtuse. Seven out of 35 patients presented with persistent dilated pouch above the twist. Two patients were lost to follow-up. Overall outcome at an average follow-up of 15.5 months after primary surgery (range 7–49 mo) was as follows: 12 clinical failures and 1 technical failure (40%) and 60% (20 out of 33) clinical success. Conclusion Pneumatic dilation of late functional helix stricture is an effective technique for treatment of dysphagia in the majority of patients treated. Complete helix stricture, defined in function of the angle within twist, as well as the presence of a persistently dilated gastric pouch above the kinking, seems to be correlated with higher failure rates. |
| Databáze: | OpenAIRE |
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