关键词: 袖状胃切除, 代谢综合征, 加速康复, 腹腔镜, 干预措施

Abstract: Objective To explore a convenient and feasible perioperative enhanced recovery interventions of laparoscopic sleeve gastrectomy (LSG).Methods Retrospective study was performed on the clinical data of 64 patients undergoing LSG in the Third People’s Hospital of Xinjiang Uygur Autonomous Region from January 2019 to June 2022,including 11 males and 53 females.Age ranged from 24 to 51 years,They were divided into 2 groups:the control group (n=31) received routine perioperative enhanced recovery and weight loss surgical interventions and the experimental group (n=33) received the adjusted perioperative enhanced recovery and weight loss surgical interventions.The operation-related indexes,laboratory indexes at 48 hours after operation and the occurrence of surgical complications (Grade Ⅰ-Ⅱ:fever,incisional infection,postoperative nausea and vomiting,epigastric pain,pulmonary infection.Grade Ⅲ-Ⅳ:pleural effusion,gastrointestinal leakage,abdominal bleeding,deep vein thrombosis.Grade V:death) were compared and analyzed between the two groups.Result There were no statistically significant differences between the 2 groups in terms of operative time,operative bleeding,number of nail bins used,unplanned increase in the number of trocar holes,time to first anal discharge,time to feed,length of hospital stay,postoperative hospital stay,and 48h postoperative white blood cell count,calcitoninogen,lactate,oxygen saturation,serum sodium,serum potassium,albumin,triglyceride and urea levels (P>0.05).The hospitalization cost,incidence of postoperative nausea and vomiting and total incidence of surgical complications were higher in the control group than in the experimental group,and the differences were statistically significant (P<0.05).Conclusion  In the perioperative enhanced recovery interventions of LSG,It is maybe safe and feasible that abdominal drainage tube and central venous catheter were not routinely placed in normal patients,and management of venous embolism were not routinely placed on the basis of early ambulation (24h after surgery) and water and food intake (24-48h after surgery) in patients without anemia,coagulopathy or not undergoing anticoagulant therapy.Gastric tube indwelling for 12-24 hours can reduce the occurrence of postoperative nausea and vomiting and upper abdominal pain.

Key words: sleeve gastrectomy, metabolic syndrome, enhanced recovery, laparoscopy, interventions