Mesentery

肠系膜
  • 文章类型: Journal Article
    在人类和兽医领域,口服疫苗引起了相当大的兴趣。在狗中,这些疫苗是新开发的,了解它们的机制至关重要。肠系膜淋巴结(MLNs)和Peyer’s斑块(PPs)是胃肠道粘膜诱导的重要部位。然而,犬MLN缺乏足够的信息。为了解决这个问题,我们从健康的狗身上收集了MLN样本,进行流式细胞术以表征免疫细胞,并进行了单细胞RNA测序(scRNA-seq)来探索亚群,特别是B和T淋巴细胞。这项工作使得能够表征犬MLN的主要细胞群体和构建预测图谱,以及对这一领域特殊性的识别。
    In the human and veterinary fields, oral vaccines generate considerable interest. In dogs, these vaccines are newly developed, and understanding their mechanisms is crucial. Mesenteric lymph nodes (MLNs) and Peyer\'s patches (PPs) are important sites for gastrointestinal mucosal induction, yet canine MLNs lack sufficient information. To address this, we collected MLN samples from healthy dogs, performed flow cytometry to characterize immune cells, and conducted single-cell RNA sequencing (scRNA-seq) to explore subpopulations, particularly B and T lymphocytes. This effort enabled the characterization of canine MLN\'s main cell populations and the construction of a predictive atlas, as well as the identification of particularities of this area.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    背景:炎症性肠病,特别是克罗恩病(CD),与肠系膜脂肪组织(MAT)的改变和称为“爬行脂肪”的现象有关。组织病理学评价显示,CD患者MAT和肠组织发生显著改变,这些组织的特征是炎症和纤维化。
    目的:为了评估MAT,爬行脂肪,炎症,和CD中的肠道微生物群。
    方法:收集12例CD患者的肠组织和MAT。分析组织学表现和蛋白质表达水平以确定病变特征。从五名最近治疗的CD患者和五名对照受试者收集粪便样品并移植到小鼠中。这些小鼠的肠道和肠系膜病变,以及他们的全身炎症状态,在移植了CD患者和对照组粪便样本的小鼠中进行评估和比较。
    结果:MAT的病理学检查显示,受CD影响的结肠和未受影响的结肠之间存在显着差异,包括肠道菌群结构的显著差异。来自临床健康供体的胎儿微生物群移植(FMT)到2,4,6-三硝基苯磺酸(TNBS)诱导的CD小鼠中,改善了CD症状,而来自CD患者的FMT进入这些小鼠会加剧CD症状。值得注意的是,FMT影响肠道通透性,屏障功能,以及促炎因子和脂肪因子的水平。此外,CD患者的FMT加剧了TNBS诱导的CD小鼠结肠组织的纤维化变化。
    结论:肠道菌群在CD的组织病理学中起关键作用。因此,靶向MAT和爬行脂肪可能具有治疗CD患者的潜力。
    BACKGROUND: Inflammatory bowel disease, particularly Crohn\'s disease (CD), has been associated with alterations in mesenteric adipose tissue (MAT) and the phenomenon termed \"creeping fat\". Histopathological evaluations showed that MAT and intestinal tissues were significantly altered in patients with CD, with these tissues characterized by inflammation and fibrosis.
    OBJECTIVE: To evaluate the complex interplay among MAT, creeping fat, inflammation, and gut microbiota in CD.
    METHODS: Intestinal tissue and MAT were collected from 12 patients with CD. Histological manifestations and protein expression levels were analyzed to determine lesion characteristics. Fecal samples were collected from five recently treated CD patients and five control subjects and transplanted into mice. The intestinal and mesenteric lesions in these mice, as well as their systemic inflammatory status, were assessed and compared in mice transplanted with fecal samples from CD patients and control subjects.
    RESULTS: Pathological examination of MAT showed significant differences between CD-affected and unaffected colons, including significant differences in gut microbiota structure. Fetal microbiota transplantation (FMT) from clinically healthy donors into mice with 2,4,6-trinitrobenzene sulfonic acid (TNBS)-induced CD ameliorated CD symptoms, whereas FMT from CD patients into these mice exacerbated CD symptoms. Notably, FMT influenced intestinal permeability, barrier function, and levels of proinflammatory factors and adipokines. Furthermore, FMT from CD patients intensified fibrotic changes in the colon tissues of mice with TNBS-induced CD.
    CONCLUSIONS: Gut microbiota play a critical role in the histopathology of CD. Targeting MAT and creeping fat may therefore have potential in the treatment of patients with CD.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Case Reports
    经心疝是一种内疝,肠系膜的缺陷导致肠loop突出。他们表现出各种各样的症状,没有任何特定的放射学特征,导致诊断延迟和高死亡率。这里,我们介绍了4例罕见但致命的小肠梗阻患者。三名儿童因小肠梗阻被送往急诊科。另一个婴儿是早产新生儿,产前扫描显示小肠梗阻。所有儿童均接受了紧急剖腹手术,发现肠系膜缺损伴小肠疝和坏疽。进行坏疽段的切除吻合和肠系膜缺损的闭合。儿童小肠梗阻的鉴别应包括跨中心疝。实验室或影像学检查通常不确定。在这种罕见但危及生命的情况下,及时的探索可以挽救生命。
    UNASSIGNED: Transmesentric hernias are a type of internal hernia, in which there is herniation of bowel loops through a defect in the mesentery. They present with a wide variety of symptoms without any specific radiological features, leading to a delay in diagnosis and high mortality rate. Here, we present a case series of four patients with this rare but fatal cause of small bowel obstruction. Three children presented to the emergency department with small bowel obstruction. The other baby was a preterm neonate with an antenatal scan showing small bowel obstruction. All children underwent emergency laparotomy and were found to have a mesenteric defect with herniation and gangrene of the small bowel. Resection anastomosis of the gangrenous segment and closure of the mesenteric defect were done. The differential for small bowel obstruction in children should include transmesentric hernia. Laboratory or imaging investigations are often inconclusive. Timely exploration can save lives in this rare but life-threatening condition.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Case Reports
    背景:异位肠系膜骨化(HMO)是一种临床上罕见的疾病,其特征是肠系膜中骨组织的形成。此类病例的全球报告仅限于医学文献中的70多个病例。HMO的病因尚不清楚,但是这种疾病可能是由机械性创伤引起的,缺血,或左下腹感染,导致间充质干细胞分化为成骨细胞。这里,我们介绍了一例罕见的HMO病例,发生在一名34岁的男性身上,出现左下腹疼痛.
    方法:我们报告了一例34岁的男性患者,他在左下腹部外伤后出现左下腹痛。他随后接受了手术治疗,术后病理诊断为HMO。
    结论:我们认为,尽管有关HMO的文献和研究有限,当具有左下腹部外伤或手术史的患者出现相应的影像学表现时,临床医生应警惕区分这种情况,并及时选择适当的诊断和治疗干预措施。
    BACKGROUND: Heterotopic mesenteric ossification (HMO) is a clinically rare condition characterized by the formation of bone tissue in the mesentery. The worldwide reporting of such cases is limited to just over 70 instances in the medical literature. The etiology of HMO remains unclear, but the disease is possibly induced by mechanical trauma, ischemia, or intra-left lower quadrant abdominal infection, leading to the differentiation of mesenchymal stem cells into osteoblasts. Here, we present a rare case of HMO that occurred in a 34-year-old male, who presented with left lower quadrant abdominal pain.
    METHODS: We report the case of a 34-year-old male patient who presented with left lower abdominal pain following trauma to the left lower abdomen. He subsequently underwent surgical treatment, and the postoperative pathological diagnosis was HMO.
    CONCLUSIONS: We believe that although there is limited literature and research on HMO, when patients with a history of trauma or surgery to the left lower abdomen present with corresponding imaging findings, clinicians should be vigilant in distinguishing this condition and promptly selecting appropriate diagnostic and therapeutic interventions.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Case Reports
    在这份报告中,我们介绍了一名亚裔男性患者,30岁,因胰腺炎入院.在做CT扫描时,在病人的腹部意外发现了一个孤立的肿块。病人的腹痛,是由胰腺炎引起的,在接受手术切除肿块之前已经解决了。随后,患者根据病理诊断为Castleman病。发生在肠系膜的Castleman病非常罕见。因此,我们回顾了有关Castleman病的基本信息,发现关键部分在于诊断和考虑基于不同类型的不同治疗策略.
    In this report, we present an Asian male patient who was 30 years old and admitted to the hospital due to pancreatitis. While undergoing a CT scan, an isolated mass was unexpectedly discovered in the patient\'s abdomen. The patient\'s abdominal pain, which was caused by pancreatitis, had resolved before he underwent surgical resection to remove the mass. Subsequently, the patient was diagnosed with Castleman disease based on pathology. Castleman disease occurring in the mesentery is exceptionally rare. Therefore, we have reviewed the essential information regarding Castleman disease and have found that the crucial part lies in the diagnosis and the consideration of distinct treatment strategies based on different types.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Case Reports
    背景:弥漫性肠道和肠系膜脂肪瘤病是一种罕见的疾病,其特征是肠道和肠系膜脂肪组织过度生长。该病例报告旨在强调这种疾病引起的慢性腹胀的罕见发生及其对肌肉层的独特侵袭,以前没有报道过。
    方法:我院胃肠外科收治一名36岁女性,有7年腹胀病史。
    方法:腹部和盆腔CT显示弥漫性小肠脂肪瘤病。
    方法:患者接受了手术。我们进行了开放野切除术,包括切除所有脂肪瘤肠(250厘米)。
    结果:在手术过程中,弥漫性结节性回肠和肠系膜脂肪瘤病得到证实,以粘膜下层和肌肉层内存在多发性结节性脂肪瘤为特征。手术干预涉及切除250厘米的受影响回肠,然后空肠吻合术.术后病理证实诊断,在粘膜下层和肌肉层都观察到病变。患者症状明显改善,在10个月的随访期内观察到正常的肠道功能和体重增加,也没有复发的迹象.
    结论:弥漫性肠道和肠系膜脂肪瘤病可导致长期腹胀。此外,它可能涉及肠壁的肌肉层。手术是症状性肠脂肪瘤病的主要治疗选择。
    BACKGROUND: Diffuse intestinal and mesenteric lipomatosis is a rare condition characterized by the overgrowth of adipose tissue in the intestines and mesentery. This case report aims to highlight the rare occurrence of chronic abdominal distention caused by this disease and its unique invasion into the muscle layer, which has not been previously reported.
    METHODS: A 36-year-old woman with a 7-year history of abdominal distension was admitted to our hospital\'s Department of Gastrointestinal Surgery.
    METHODS: Abdominal and pelvic computed tomography revealed diffuse small intestinal lipomatosis.
    METHODS: The patient underwent surgery. We performed an open-field ilectomy involving removal of all lipomatous intestines (250 cm).
    RESULTS: During the surgery, diffuse nodular ileal and mesenteric lipomatosis was confirmed, characterized by the presence of multiple nodular lipomas within the submucosal and muscular layers. The surgical intervention involved the resection of 250 cm of the affected ileum, followed by jejunoileal anastomosis. Postoperative pathology confirmed the diagnosis, with lesions observed in both the submucosa and muscle layers. The patient showed significant improvement in symptoms, with normal intestinal function and weight gain observed over a 10-month follow-up period, and no signs of recurrence.
    CONCLUSIONS: Diffuse intestinal and mesenteric lipomatosis can lead to long-term abdominal distension. Additionally, it may be involved in the muscle layer of the intestinal wall. Surgery is the primary treatment option for symptomatic intestinal lipomatosis.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    肠道免疫系统在诱导针对食物的免疫反应中起着关键作用。在T细胞反应的情况下,树突状细胞(DC)尤其重要。然而,肠道DCs对食物免疫反应的调节一直缺乏描述。在这项研究中,我们分析了乳酸乳球菌亚种的作用。cremorisYRC3780,一种从开菲尔分离的乳酸菌菌株,一种传统的发酵奶制品,关于肠道DC对T细胞的抗原呈递诱导的免疫应答以及这些免疫调节作用的作用机制。已经显示,在动物和人类研究中,L.cremorisYRC3780改善花粉症的症状。
    将来自BALB/c小鼠的肠系膜淋巴结(MLN)的CD11c+细胞作为MLNDCs与CremorisL.YRC3780一起培养,并通过qPCR检查诱导调节性T细胞(Tregs)的基因表达。此外,MLNDC与来自DO11.10转基因小鼠的CD4+T细胞共培养,所述小鼠表达卵清蛋白(OVA)特异性TCR和OVA抗原肽和CremorisL.YRC3780。通过流式细胞术检查Tregs的诱导,通过DNA微阵列和qPCR分析基因表达,并通过ELISA测量细胞因子的产生。使用来自TLR2缺陷型小鼠的MLNDCs和CremorisL.YRC3780的组分来检查MLNDCs对YRC3780的识别。
    L.cremorisYRC3780增强了MLNDC中Treg诱导基因的表达,并在MLNDC和CD4T细胞共培养系统中诱导了Foxp3CD4T细胞。对MLNDCs的作用可能是由TLR2以外的受体介导的。结合CD4+T细胞基因表达和细胞因子ELISA的微阵列分析,已经证明了乳脂乳杆菌YRC3780促进了Th1和Tregs的诱导,并通过MLNDCs的抗原呈递调节涉及多个基因的Th1/Th2和Treg/Th17细胞的平衡。
    我们的发现为DC介导的肠道免疫应答的调节和乳酸菌的抗过敏作用提供了见解。
    UNASSIGNED: The intestinal immune system plays a pivotal role in the induction of immune responses against food. In the case of T cell response, dendritic cells (DCs) are especially important. However, the regulation of immune responses to food by intestinal DCs has been poorly described. In this study, we analyzed the effect of Lactococcus lactis subsp. cremoris YRC3780, a lactic acid bacterial strain isolated from kefir, a traditional fermented milk product, on the immune responses induced by antigen presentation by intestinal DCs to T cells as well as the mechanism of action of these immunomodulatory effects. It has been shown that L. cremoris YRC3780 ameliorates the symptoms of pollinosis in both animal and human studies.
    UNASSIGNED: CD11c+ cells from mesenteric lymph nodes (MLNs) of BALB/c mice were cultured as MLN DCs with L. cremoris YRC3780 and expression of genes inducing regulatory T cells (Tregs) was examined by qPCR. In addition, MLN DCs were cocultured with CD4+ T cells from DO11.10 transgenic mice expressing an ovalbumin (OVA)-specific TCR and the OVA antigen peptide and L. cremoris YRC3780. Induction of Tregs was examined by flow cytometry, gene expression was analyzed by DNA microarray and qPCR, and the production of cytokines was measured by ELISA. MLN DCs from TLR2-deficient mice and components of L. cremoris YRC3780 were used to examine the recognition of YRC3780 by MLN DCs.
    UNASSIGNED: L. cremoris YRC3780 enhanced the expression of genes involved in Treg induction in MLN DCs and induced Foxp3+CD4+T cells in an MLN DC and CD4+ T-cell co-culture system. The effect on MLN DCs was likely mediated by receptors other than TLR2. Together with microarray analyses of CD4+ T cell gene expression and cytokine ELISA, it was demonstrated that L. cremoris YRC3780 promoted the induction of Th1 and Tregs, and regulated the balance of Th1/Th2 and Treg/Th17 cells involving multiple genes via the antigen-presentation of MLN DCs.
    UNASSIGNED: Our findings provide insights into the modulation of intestinal immune responses mediated by DCs and the antiallergic effects of lactic acid bacteria.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    肠系膜脂膜炎(MP)是一种罕见的脂肪组织非肿瘤性特发性炎症,主要影响小肠的肠系膜,其病因在很大程度上仍然是推测性的。女性和男性中MP患病率的差异在多项研究中有所不同。在大多数情况下,MP是无症状的;然而,患者可出现非特异性腹部症状,或可模仿潜在的胃肠道和腹部疾病。诊断由计算机断层扫描提示,必要时通常通过手术活检证实。治疗通常是支持性的,并基于一些选定的药物,即,非甾体抗炎药或皮质类固醇。当诊断不明确时,保留手术,当怀疑恶性肿瘤或严重表现如肿块效应时,肠梗阻,或缺血性改变。
    MP是一种罕见的肠系膜炎症性疾病,通常无症状,但可引起非特异性腹部症状。诊断依赖于计算机断层扫描成像,治疗主要是支持性的,使用非甾体抗炎药或皮质类固醇等药物,而手术保留用于严重病例或诊断不确定性。
    MP引起腹痛,主要通过CT扫描诊断。
    UNASSIGNED: Mesenteric panniculitis (MP) is an uncommon non-neoplastic idiopathic inflammation of adipose tissue, mainly affecting the mesentery of the small intestine, with its etiology remaining largely speculative. The difference in prevalence of MP among females and males varies across multiple studies. In most cases, MP is asymptomatic; however, patients can present with nonspecific abdominal symptoms or can mimic underlying gastrointestinal and abdominal diseases. The diagnosis is suggested by computed tomography and is usually confirmed by surgical biopsies if necessary. Treatment is generally supportive and based on a few selected drugs, namely, nonsteroidal anti-inflammatory drugs or corticosteroids. Surgery is reserved when the diagnosis is unclear, when malignancy is suspected or in the case of severe presentation such as mass effect, bowel obstruction, or ischemic changes.
    UNASSIGNED: MP is a rare inflammatory condition of the mesentery often asymptomatic but can cause nonspecific abdominal symptoms. Diagnosis relies on computed tomography imaging, with treatment mainly supportive, utilizing medications like nonsteroidal anti-inflammatory drugs or corticosteroids, while surgery is reserved for severe cases or diagnostic uncertainty.
    UNASSIGNED: MP causes abdominal pain, and it is mainly diagnosed with CT scan.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    背景:间充质干细胞(MSC)在炎症性肠病(IBD)的治疗中表现出广泛的治疗能力。腹膜内注射MSCs对IBD的治疗效果优于静脉注射。然而,腹膜内注射后MSCs的精确体内分布及其生物学后果仍未得到充分理解.需要进一步的研究来探索MSCs分布与其生物学效应之间的相关性。
    方法:首先,腹膜内注射hUC-MSCs后,分析人脐带MSCs(hUC-MSCs)的分布以及肠系膜淋巴结(MLN)中Treg和Th17细胞的数量。随后,调查集中在转化生长因子β1(TGF-β1)的水平,Treg和Th17细胞生物学的关键细胞因子,在结肠炎小鼠的组织中,特别是在MLN中。该研究还探讨了hUC-MSCs治疗对MLN中Treg细胞计数的影响,以及TGFB1敲除hUC-MSCs对Treg细胞分化和IBD医治的后果。
    结果:发现腹膜内给药hUC-MSCs治疗结肠炎的治疗效果是显著的,这与它们向MLN的快速迁移和TGF-β1的分泌密切相关。结肠炎小鼠MLN中hUC-MSCs的丰度远高于其他器官甚至结肠发炎部位。腹膜内注射hUC-MSCs导致Treg细胞数量的显着增加和Th17细胞的减少,尤其是在MLN中。此外,TGF-β1的浓度,Treg分化的关键细胞因子,也发现在hUC-MSC治疗后MLN中显著升高。在hUC-MSC中TGFB1的敲除导致MLN中Treg细胞的显著减少和在结肠炎中hUC-MSC治疗的最终失败。
    结论:MLNs可能是hUC-MSCs对Treg/Th17细胞的调节作用以及对结肠炎的治疗作用的关键位点。源自hUC-MSC的TGF-β1促进MLN中的局部Treg分化。本研究将为制定基于MSC的IBD治疗策略提供新的思路。
    BACKGROUND: Mesenchymal stem cells (MSCs) demonstrate a wide range of therapeutic capabilities in the treatment of inflammatory bowel disease (IBD). The intraperitoneal injection of MSCs has exhibited superior therapeutic efficacy on IBD than intravenous injection. Nevertheless, the precise in vivo distribution of MSCs and their biological consequences following intraperitoneal injection remain inadequately understood. Additional studies are required to explore the correlation between MSCs distribution and their biological effects.
    METHODS: First, the distribution of human umbilical cord MSCs (hUC-MSCs) and the numbers of Treg and Th17 cells in mesenteric lymph nodes (MLNs) were analyzed after intraperitoneal injection of hUC-MSCs. Subsequently, the investigation focused on the levels of transforming growth factor beta1 (TGF-β1), a key cytokine to the biology of both Treg and Th17 cells, in tissues of mice with colitis, particularly in MLNs. The study also delved into the impact of hUC-MSCs therapy on Treg cell counts in MLNs, as well as the consequence of TGFB1 knockdown hUC-MSCs on the differentiation of Treg cells and the treatment of IBD.
    RESULTS: The therapeutic effectiveness of intraperitoneally administered hUC-MSCs in the treatment of colitis was found to be significant, which was closely related to their quick migration to MLNs and secretion of TGF-β1. The abundance of hUC-MSCs in MLNs of colitis mice is much higher than that in other organs even the inflamed sites of colon. Intraperitoneal injection of hUC-MSCs led to a significant increase in the number of Treg cells and a decrease in Th17 cells especially in MLNs. Furthermore, the concentration of TGF-β1, the key cytokine for Treg differentiation, were also found to be significantly elevated in MLNs after hUC-MSCs treatment. Knockdown of TGFB1 in hUC-MSCs resulted in a noticeable reduction of Treg cells in MLNs and the eventually failure of hUC-MSCs therapy in colitis.
    CONCLUSIONS: MLNs may be a critical site for the regulatory effect of hUC-MSCs on Treg/Th17 cells and the therapeutic effect on colitis. TGF-β1 derived from hUC-MSCs promotes local Treg differentiation in MLNs. This study will provide new ideas for the development of MSC-based therapeutic strategies in IBD patients.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    背景:Roux-Y胃旁路术(RYGB)后的内疝(IH)如果不及时识别和治疗,可导致小肠缺血延长。这项研究的目的是显示肠系膜缺损(MD)闭合的改善是否会降低IH的发生率。
    方法:回顾性分析从我们的数据库中收集的前瞻性数据,包括1999年至2015年接受腹腔镜RYGB的所有患者。通常的技术是后绞痛/胃后RYGB。我们根据MD的闭合技术将患者分为四组,并比较两组之间的IH发生率。所有患者都有至少8年的随访。
    结果:共有1927名患者(1497名女性/460名男性,平均年龄41.5±11岁)进行手术。1747例(90.7%)进行了回绞痛/胃后RYGB,180例进行了RYGB。平均随访时间为15(8-24)年。111例患者(5.8%)发生IH,大多数是通过空肠空肠造口术(JJ,3.7%)和彼得森(1.7%)缺陷。随着闭合技术的改进,发病率随着时间的推移而下降,从使用单独缝线组的12.9%到最近使用不可吸收缝线和JJ缺损处额外荷包的1.05%(p<0.0001)。
    结论:在RYGB期间精心闭合MD是非常重要的步骤,可以显着降低RYGB后的IH风险,即使有绞痛/胃后解剖结构。在JJ处使用非吸收性编织缝合线和额外的荷包缝合线是最有效的技术,但是很小的IH风险仍然存在。RYGB后出现急性腹痛的患者仍然需要高度怀疑。
    BACKGROUND: Internal hernia (IH) after Roux-Y gastric bypass (RYGB) can lead to extended small bowel ischemia if it not recognized and treated promptly. The aim of this study is to show whether improvement in mesenteric defect (MD) closure reduces the incidence of IH.
    METHODS: Retrospective analysis of prospectively collected data from our database including all patients who underwent laparoscopic RYGB between 1999 and 2015. The usual technique was a retrocolic/retrogastric RYGB. We divided patients in four groups according to the closure technique for MD and compared incidences of IH between groups. All patients had at least 8 years of follow-up.
    RESULTS: A total of 1927 patients (1497 females/460 males, mean age of 41.5 ± 11 years) were operated. A retrocolic/retrogastric RYGB was performed in 1747 (90.7%) and an antecolic RYGB in 180 patients. Mean duration of follow-up was 15 (8-24) years. 111 patients (5.8%) developed IH, the majority through the jejunojejunostomy (JJ, 3.7%) and Petersen (1.7%) defects. With improvement of closure technique, the incidence decreased over time, from 12.9% in the group with separate sutures to 1.05% in the most recent group with running non-absorbable sutures and an additional purse-string at the JJ defect (p < 0.0001).
    CONCLUSIONS: Meticulous closure of MD during RYGB is a very important step that significantly reduces the IH risk after RYGB, even with a retrocolic/retrogastric anatomy. Using running non absorbable braided sutures and an additional purse-string suture at the JJ is the most effective technique, but a small IH risk persists. A high index of suspicion remains necessary in patients who present with acute abdominal pain after RYGB.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

公众号