Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery · 2024
Surgical management of candy cane syndrome after Roux-en-Y bypass.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Celik Nafiye Busra, Cornejo Jorge, Evans Lorna A, Elli Enrique F
Аннотация
BACKGROUND: Candy cane (CC) syndrome is a complication that occurs following Roux-en-Y bypass (RYGB), implicated as a long, small-bowel blind limb at gastrojejunostomy possibly caused using circular staplers.
OBJECTIVES: We aimed to report our experience with CC resection and improving outcomes following RYGB.
SETTING: University hospital.
METHODS: We performed a retrospective analysis of patients who underwent CC resection at our institution from 2017 to 2023. Patient's charts were then reviewed to evaluate for symptoms, operative, and weight data. Only patients with an afferent blind limb in the most direct outlet from the gastroesophageal junction (GJ) visualized in upper gastrointestinal (GI) study and endoscopy were included.
RESULTS: Twenty-nine patients had presented with symptoms of and underwent surgery of resection of the CC (83% female; 50.3 ± 12.9 years) within 11 ± 6 years after initial RYGB. In addition, 58.6% underwent a concomitant procedure (10 hiatal hernia repair, 4 revision gastrojejunostomy, and 3 internal hernia reduction and defect closure). The mean length of the CC was 7.5 ± 3.9 cm. Resection of CC was performed in 62.1% as stapling only, 34.5% as stapling and oversewing, and 3.4% as oversewing only. The 30-day hospital readmission rate was 7.4% (n = 2). At 8.5-month follow-up, there was a significant reduction (P < .005) of bloating, nausea or vomiting, and dysphagia; however, abdominal pain and diarrhea slightly decreased. The estimated weight loss percentage was 29.4% ± 5.6%, and body mass index decreased from 32.1 ± 7.3 kg/m2 to 29.1 ± 4.7 kg/m2.
CONCLUSIONS: Resection of blind afferent limb can be managed safely with excellent outcomes and resolution of symptoms, even if major procedures are performed concomitantly. Surgeons should resect excess Roux limb in the initial RYGB to decrease the likelihood of this syndrome.
OBJECTIVES: We aimed to report our experience with CC resection and improving outcomes following RYGB.
SETTING: University hospital.
METHODS: We performed a retrospective analysis of patients who underwent CC resection at our institution from 2017 to 2023. Patient's charts were then reviewed to evaluate for symptoms, operative, and weight data. Only patients with an afferent blind limb in the most direct outlet from the gastroesophageal junction (GJ) visualized in upper gastrointestinal (GI) study and endoscopy were included.
RESULTS: Twenty-nine patients had presented with symptoms of and underwent surgery of resection of the CC (83% female; 50.3 ± 12.9 years) within 11 ± 6 years after initial RYGB. In addition, 58.6% underwent a concomitant procedure (10 hiatal hernia repair, 4 revision gastrojejunostomy, and 3 internal hernia reduction and defect closure). The mean length of the CC was 7.5 ± 3.9 cm. Resection of CC was performed in 62.1% as stapling only, 34.5% as stapling and oversewing, and 3.4% as oversewing only. The 30-day hospital readmission rate was 7.4% (n = 2). At 8.5-month follow-up, there was a significant reduction (P < .005) of bloating, nausea or vomiting, and dysphagia; however, abdominal pain and diarrhea slightly decreased. The estimated weight loss percentage was 29.4% ± 5.6%, and body mass index decreased from 32.1 ± 7.3 kg/m2 to 29.1 ± 4.7 kg/m2.
CONCLUSIONS: Resection of blind afferent limb can be managed safely with excellent outcomes and resolution of symptoms, even if major procedures are performed concomitantly. Surgeons should resect excess Roux limb in the initial RYGB to decrease the likelihood of this syndrome.