Clinical comparative observation of continuous and interrupted suture of omentopexy in laparoscopic sleeve gastrectomy / 国际外科学杂志

Objective:To compare the safety of continuous suture and interrupted suture in Laparoscopic Sleeve Gastrectomy and Omentopexy.Methods:The retrospective study include 121 patients who underwent Laparoscopic Sleeve Gastrectomy and Omentopexy in the Department of Obesity and Metabolic Surgery of the First Affiliated Hospital of Jinan University from January 2019 to March 2020.Among the 121 patients, 40 were males and 81 females, with an average age of (30.17±10.16) and (27.10±11.03), respectively. Among them, 70 patients used continuous suture during OP (continuous suture group), and 51 patients used intermittent suture (interrupted suture group). The operation time, intraoperative blood loss, postoperative pain score, postoperative complications were compared between the two groups. Normally distributed measurement data were measured as (mean ± standard) deviation ( Mean± SD), and t test was used to count the comparison between the two groups. The χ2 test was used to compare the measurement data between groups. The rank data used Wilconxon rank sum test. Results:(1) Intraoperative conditions: the operative time and intraoperative blood loss in the continuous suture group were (124.89±37.69) min and (7.3±2.5) mL, respectively. In the interrupted suture group, the above indexes were (124.80±35.53) min and (7.0±2.5) mL, respectively. There was no significant difference between the two groups ( t=0.012, 0.709, P>0.05). (2) Postoperative conditions: postoperative pain score and postoperative hospital stay in the continuous suture group were: mild pain in 45 cases, moderate pain in 25 cases, painless and severe pain in 0 cases, (9.3±3.2) d, respectively. In the interrupted suture group, the above indicators were 39 cases of mild pain, 12 cases of moderate pain, 0 cases of painless and severe pain, (8.7±2.1) d, and there was no statistical significance between the two groups ( Z=-1.431, P>0.05, t=1.149, P>0.05). In the continuous suture group, postoperative abdominal distension occurred in 8 cases, nausea and vomiting in 32 cases, gastroesophageal reflux in 17 cases by upper digestive tract imaging, contrast agent slowly passed through the residual stomach/anastomotic site in 14 cases, gastric volvulus in 6 cases, and no postoperative infection or anastomotic leakage occurred. In the interrupted suture group, the above indexes were 10 cases, 25 cases, 14 cases, 10 cases, gastric volvulus in 1 cases, and no postoperative infection or anastomotic leakage occurred. There was no significant difference in the above indicators between the two groups ( χ2=1.559, 0.010, 0.155, 0.003, 1.308, P>0.05). Conclusions:In laparoscopic sleeve gastrectomy and omentopexy, there is no significant difference between the continuous suture and interrupted suture in terms of operation time, intraoperative blood loss and postoperative complications. The surgeon can choose a suitable suture method based on his own judgment and experience.

Psychiatric Evaluation and Intervention in a Weight Loss Surgery Program: A Review / 신경정신의학

OBJECTIVES: Weight loss surgery (WLS) is an effective treatment for morbidly obese patients. A pre- and postoperative multimodal team-based approach is essential for maximizing the efficacy of WLS. Although there is currently no standard psychiatric approach in WLS programs, this paper summarizes the value and methods of assessment and intervention suggested in the literature. METHODS: A Pubmed search of English-language reports (1985 to 2010) and a manual search of bibliographies of related papers were reviewed. Relevant clinical information was extracted. RESULTS: Patients receiving WLS show a substantial prevalence of psychopathology, including depression, anxiety, and eating disorders, and also impaired quality of life. Most psychiatric symptoms and impaired psychosocial functioning tend to be improved after WLS, and this improvement is one of the important goals of WLS besides weight loss. However, outcomes are not promising in all patients, and the literature suggests that some psychiatric variables have prognostic value. One of the most widely researched poor prognostic factors is postoperative binge eating disorder. The identification of vulnerable patients and the offer of an appropriate intervention may be critical for their future full recovery. CONCLUSION: There are several reasons why psychiatric evaluation and intervention are worthwhile in a WLS program. Further researches will be required for the establishment of prognostic psychological factors, their biological mechanisms, and clinical guidelines for psychiatric assessment and intervention.

Psychiatric Evaluation and Intervention in a Weight Loss Surgery Program: A Review / 신경정신의학

OBJECTIVES: Weight loss surgery (WLS) is an effective treatment for morbidly obese patients. A pre- and postoperative multimodal team-based approach is essential for maximizing the efficacy of WLS. Although there is currently no standard psychiatric approach in WLS programs, this paper summarizes the value and methods of assessment and intervention suggested in the literature. METHODS: A Pubmed search of English-language reports (1985 to 2010) and a manual search of bibliographies of related papers were reviewed. Relevant clinical information was extracted. RESULTS: Patients receiving WLS show a substantial prevalence of psychopathology, including depression, anxiety, and eating disorders, and also impaired quality of life. Most psychiatric symptoms and impaired psychosocial functioning tend to be improved after WLS, and this improvement is one of the important goals of WLS besides weight loss. However, outcomes are not promising in all patients, and the literature suggests that some psychiatric variables have prognostic value. One of the most widely researched poor prognostic factors is postoperative binge eating disorder. The identification of vulnerable patients and the offer of an appropriate intervention may be critical for their future full recovery. CONCLUSION: There are several reasons why psychiatric evaluation and intervention are worthwhile in a WLS program. Further researches will be required for the establishment of prognostic psychological factors, their biological mechanisms, and clinical guidelines for psychiatric assessment and intervention.