Abstract：
BACKGROUND: Single-anastomosis metabolic/bariatric surgery procedures may lessen the incidence of anastomotic complications. This study aimed to evaluate the feasibility and safety of performing side-to-side duodenoileal (DI) bipartition using magnetic compression anastomosis (MCA). In addition, preliminary efficacy, quality of life (QoL), and distribution of food through the DI bipartition were evaluated.
METHODS: Patients with a body mass index (BMI) of ≥35.0 to 50.0 kg/m2 underwent side-to-side DI bipartition with the magnet anastomosis system (MS) with sleeve gastrectomy (SG). By endoscopic positioning, a distal magnet (250 cm proximal to the ileocecal valve) and a proximal magnet (first part of the duodenum) were aligned with laparoscopic assistance to inaugurate MCA. An isotopic study assessed transit through the bipartition.
RESULTS: Between March 14, 2022 to June 1, 2022, 10 patients (BMI of 44.2 ± 1.3 kg/m2) underwent side-to-side MS DI. In 9 of 10 patients, an SG was performed concurrently. The median operative time was 161.0 minutes (IQR, 108.0-236.0), and the median hospital stay was 3 days (IQR, 2-40). Paired magnets were expelled at a median of 43 days (IQR, 21-87). There was no device-related serious advanced event within 1 year. All anastomoses were patent with satisfactory diameters after magnet expulsion and at 1 year. Respective BMI, BMI reduction, and total weight loss were 28.9 ± 1.8 kg/m2, 15.2 ± 1.8 kg/m2, and 34.2% ± 4.1%, respectively. Of note, 70.0% of patients reported that they were very satisfied. The isotopic study found a median of 19.0% of the meal transited through the ileal loop.
CONCLUSIONS: Side-to-side MCA DI bipartition with SG in adults with class II to III obesity was feasible, safe, and efficient with good QoL at 1-year follow-up. Moreover, 19% of ingested food passed directly into the ileum.
METHODS: Patients with a body mass index (BMI) of ≥35.0 to 50.0 kg/m2 underwent side-to-side DI bipartition with the magnet anastomosis system (MS) with sleeve gastrectomy (SG). By endoscopic positioning, a distal magnet (250 cm proximal to the ileocecal valve) and a proximal magnet (first part of the duodenum) were aligned with laparoscopic assistance to inaugurate MCA. An isotopic study assessed transit through the bipartition.
RESULTS: Between March 14, 2022 to June 1, 2022, 10 patients (BMI of 44.2 ± 1.3 kg/m2) underwent side-to-side MS DI. In 9 of 10 patients, an SG was performed concurrently. The median operative time was 161.0 minutes (IQR, 108.0-236.0), and the median hospital stay was 3 days (IQR, 2-40). Paired magnets were expelled at a median of 43 days (IQR, 21-87). There was no device-related serious advanced event within 1 year. All anastomoses were patent with satisfactory diameters after magnet expulsion and at 1 year. Respective BMI, BMI reduction, and total weight loss were 28.9 ± 1.8 kg/m2, 15.2 ± 1.8 kg/m2, and 34.2% ± 4.1%, respectively. Of note, 70.0% of patients reported that they were very satisfied. The isotopic study found a median of 19.0% of the meal transited through the ileal loop.
CONCLUSIONS: Side-to-side MCA DI bipartition with SG in adults with class II to III obesity was feasible, safe, and efficient with good QoL at 1-year follow-up. Moreover, 19% of ingested food passed directly into the ileum.
摘要：
背景：单吻合术代谢/减肥手术可以减少吻合并发症的发生率。本研究旨在评估使用磁压缩吻合术（MCA）进行左右十二指肠回肠（DI）两置的可行性和安全性。此外,初步疗效,生活质量（QoL），并评估了通过DI双分区的食物分布。
方法：身体质量指数（BMI）≥35.0至50.0kg/m2的患者接受了磁铁吻合系统（MS）和袖状胃切除术（SG）的左右DI分配。通过内窥镜定位，在腹腔镜辅助下将远端磁铁（回盲瓣近端250厘米）和近端磁铁（十二指肠的第一部分）对齐，以启动MCA。一项同位素研究评估了通过双分区的过境。
结果：在2022年3月14日至2022年6月1日之间，有10名患者（BMI为44.2±1.3kg/m2）接受了侧向MSDI。在10名患者中，有9名同时进行SG。中位手术时间为161.0分钟(IQR，108.0-236.0),中位住院时间为3天(IQR，2-40).配对磁体在中位数为43天的时间内排出(IQR，21-87).1年内未发生与器械相关的严重晚期事件。在磁铁排出后和1年时，所有吻合均为专利，直径令人满意。各自的BMI,BMI降低,和总重量损失分别为28.9±1.8kg/m2，15.2±1.8kg/m2和34.2％±4.1％，分别。值得注意的是，70.0%的患者表示非常满意。同位素研究发现，通过回肠环转运的餐食的中位数为19.0％。
结论：在II级至III级肥胖的成年人中，与SG并排分配MCADI是可行的，安全,1年随访时QoL良好，效率高。此外，19%的摄入食物直接进入回肠。
方法：身体质量指数（BMI）≥35.0至50.0kg/m2的患者接受了磁铁吻合系统（MS）和袖状胃切除术（SG）的左右DI分配。通过内窥镜定位，在腹腔镜辅助下将远端磁铁（回盲瓣近端250厘米）和近端磁铁（十二指肠的第一部分）对齐，以启动MCA。一项同位素研究评估了通过双分区的过境。
结果：在2022年3月14日至2022年6月1日之间，有10名患者（BMI为44.2±1.3kg/m2）接受了侧向MSDI。在10名患者中，有9名同时进行SG。中位手术时间为161.0分钟(IQR，108.0-236.0),中位住院时间为3天(IQR，2-40).配对磁体在中位数为43天的时间内排出(IQR，21-87).1年内未发生与器械相关的严重晚期事件。在磁铁排出后和1年时，所有吻合均为专利，直径令人满意。各自的BMI,BMI降低,和总重量损失分别为28.9±1.8kg/m2，15.2±1.8kg/m2和34.2％±4.1％，分别。值得注意的是，70.0%的患者表示非常满意。同位素研究发现，通过回肠环转运的餐食的中位数为19.0％。
结论：在II级至III级肥胖的成年人中，与SG并排分配MCADI是可行的，安全,1年随访时QoL良好，效率高。此外，19%的摄入食物直接进入回肠。
