A comparative study on perioperative blood management measures in single-port laparoscopic sleeve gastrectomy

doi:10.3877/cma.j.issn.1674-3946.2026.01.007

Abstract

Abstract:

Objective

To compare the effects of different perioperative blood management measures in single-port laparoscopic sleeve gastrectomy.

Methods

The clinical data of 86 patients who underwent single-port laparoscopic sleeve gastrectomy in the Department of Bariatric and Metabolic Surgery, Nanjing Drum Tower Hospital, Nanjing University Medical School from January 2024 to October 2024 were retrospectively analyzed. The patients were divided into the experimental group (n=40 perioperative blood management was implemented, including intravenous iron infusion, etc.) and the control group (n=46, no perioperative blood management was implemented). Data were analyzed using SPSS 27.0 software. Data were expressed as (±s) or [cases (%)]. t test, χ² test or Fisher’s exact probability test were used. P<0.05 was considered statistically significant.

Results

The operation time, postoperative exhaust time, postoperative hemoglobin level decline and intraoperative blood loss in the experimental group were all less than those in the control group (P<0.05); the postoperative D-dimer and fibrinogen levels in the experimental group were higher than those in the control group, but the difference was not statistically significant (P>0.05); the postoperative neutrophil percentage and C-reactive protein level in the experimental group were significantly lower than those in the control group (P<0.05); the incidence of postoperative complications and adverse reactions in the control group was slightly higher than that in the experimental group, but the difference was not statistically significant (P>0.05).

Conclusion

Perioperative blood management measures in single-port laparoscopic sleeve gastrectomy play a crucial role in the prognosis of patients. For patients with preoperative anemia and abnormal coagulation indicators, corresponding blood management measures should be routinely implemented to improve surgical efficacy and patient prognosis.

Key words: Obesity, Single Incision Laparoscopic Sleeve Gastrectomy, Blood Management

Xing Kang, Hang Yu, Xiaodong Shan, Xitai Sun, Xuehui Chu. A comparative study on perioperative blood management measures in single-port laparoscopic sleeve gastrectomy[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2026, 20(01): 18-21.

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Figures/Tables 3

References 24

[1]	Jiang Z, Zhang Z, Feng T, et al. Trocar number and placement for laparoscopic sleeve gastrectomy and comparison of single-incision and conventional laparoscopic sleeve gastrectomy: a systematic review and meta-analysis [J]. Int J Surg, 2023, 109(6): 1783-1795.
[2]	Courcoulas AP, Patti ME, Hu B, et al. Long-Term Outcomes of Medical Management vs Bariatric Surgery in Type 2 Diabetes[J]. JAMA, 2024, 331(8): 654-664.
[3]	Chen Z, Cao B, Liu L, et al. Association between obesity and anemia in an nationally representative sample of United States adults: a cross-sectional study [J]. Front Nutr, 2024, 11: 1304127.
[4]	王勇. 中国肥胖及代谢疾病外科治疗指南（2024版）[Z].
[5]	Kolb H. Obese visceral fat tissue inflammation: from protective to detrimental? [J]. BMC Med, 2022, 20(1): 494.
[6]	Xu S, Lu F, Gao J, et al. Inflammation-mediated metabolic regulation in adipose tissue [J]. Obes Rev, 2024, 25(6): e13724.
[7]	Fuchs A, Samovski D, Smith GI, et al. Associations Among Adipose Tissue Immunology, Inflammation, Exosomes and Insulin Sensitivity in People With Obesity and Nonalcoholic Fatty Liver Disease [J]. Gastroenterol, 2021, 161(3): 968-981. e12.
[8]	傅涛, 金炜东. 肥胖症与2型糖尿病的外科治疗机制研究进展[J/CD]. 中华普外科手术学杂志（电子版）, 2020, 14(06): 639-642
[9]	Perdomo CM, Cohen RV, Sumithran P, et al. Contemporary medical, device, and surgical therapies for obesity in adults[J]. Lancet, 2023, 401(10382): 1116-1130.
[10]	Yadav J, Liang T, Qin T, et al. Gut microbiome modified by bariatric surgery improves insulin sensitivity and correlates with increased brown fat activity and energy expenditure[J]. Cell Rep Med, 2023, 4(5): 101051.
[11]	Yu H, Qian L, Yan Y, et al. Analysis of the efficacy of sleeve gastrectomy, one-anastomosis gastric bypass, and single-anastomosis sleeve ileal bypass in the treatment of metabolic syndrome [J]. Scient Rep, 2024, 14(1): 5069.
[12]	Benotti PN, Wood GC, Dove JT, et al. Iron deficiency is highly prevalent among candidates for metabolic surgery and may affect perioperative outcomes[J]. Surg Obes Relat Dis, 2021, 17(10): 1692-1699.
[13]	Musallam KM, Tamim HM, Richards T, et al. Preoperative anaemia and postoperative outcomes in non-cardiac surgery: a retrospective cohort study[J]. Lancet (London, England), 2011, 378(9800): 1396-1407.
[14]	静脉铁剂应用中国专家共识（2019年版）. [2024-12-07]. URL
[15]	Yeo E, Thompson J, Hanseman D, et al. Increased staple loading pressures and reduced staple heights in laparoscopic sleeve gastrectomy reduce intraoperative bleeding [J]. Surg, 2021, 169(5): 1110-1115.
[16]	颜帅, 胡旭, 苟晓梅, 等. 腹腔镜胃袖状切除术后并发症处置策略[J/CD]. 中华普外科手术学杂志（电子版）, 2024, 18(02): 220-224.
[17]	Ying LD, Duffy AJ, Roberts KE, et al. Intraoperative Blood Pressure Lability Is Associated with Postoperative Hemorrhage after Uncomplicated Bariatric Surgery[J]. Obes Surg, 2019, 29(6): 1990-1994.
[18]	Sroka G, Milevski D, Shteinberg D, et al. Minimizing Hemorrhagic Complications in Laparoscopic Sleeve Gastrectomy--a Randomized Controlled Trial [J]. Obes Surg, 2015, 25(9): 1577-1583.
[19]	Luo L, Li H, Wu Y, et al. Portal venous system thrombosis after bariatric surgery: A systematic review and meta-analysis[J]. Surg, 2021, 170(2): 363-372.
[20]	Naymagon L, Tremblay D, Mascarenhas J, et al. Characteristics, anticoagulation, and outcomes of portal vein thrombosis after intra-abdominal surgery [J]. Surg, 2021, 169(5): 1175-1181.
[21]	Abildgaard A, Madsen SA, Hvas AM. Dosage of Anticoagulants in Obesity: Recommendations Based on a Systematic Review [J]. Semin Thromb Hemost, 2020, 46(8): 932-969.
[22]	Birkmeyer NJO, Finks JF, Carlin AM, et al. Comparative effectiveness of unfractionated and low-molecular-weight heparin for prevention of venous thromboembolism following bariatric surgery [J]. Arch Surg, 2012, 147(11): 994-998.
[23]	王利华, 王丽娟, 杨会义, 等. 气压疗法对术后下肢静脉血栓形成的防治作用研究[J]. 中国全科医学, 2023, 26(26): 3337.
[24]	围手术期患者血液管理指南-中华人民共和国国家卫生健康委员会[EB/OL]. [2024-12-07]. URL

组别	例数	性别（例）	年龄（岁，±s）	体重（kg，±s）	BMI（kg/m²，±s）	输血史[例（%）]
组别	例数	男/女	年龄（岁，±s）	体重（kg，±s）	BMI（kg/m²，±s）	输血史[例（%）]
实验组	40	15/25	27.8±8.2	148.6±48.5	36.5±4.7	2（5.0）
对照组	46	17/29	28.5±7.5	152.3±51.3	37.2±4.9	1（2.2）
t/χ²值			-1.256	0.893	1.243	<0.001
P值			0.157	0.125	0.114	1.151
组别	例数	腹部手术史[例（%）]	白细胞（×10⁹/L，±s）	血红蛋白（g/L，±s）	D-二聚体（mg/L，±s）	纤维蛋白原（g/L，±s）
实验组	40	4（10.0）	8.6±1.6	123.7±2.3	0.3±0.2	3.8±0.8
对照组	46	3（6.5）	8.3±1.2	124.7±3.8	0.2±0.1	3.2±0.8
t/χ²值		<0.001	-1.354	0.812	1.456	-2.354
P值		0.721	0.187	0.158	0.387	0.354

组别	例数	性别（例）	年龄（岁，±s）	体重（kg，±s）	BMI（kg/m²，±s）	输血史[例（%）]
组别	例数	男/女	年龄（岁，±s）	体重（kg，±s）	BMI（kg/m²，±s）	输血史[例（%）]
实验组	40	15/25	27.8±8.2	148.6±48.5	36.5±4.7	2（5.0）
对照组	46	17/29	28.5±7.5	152.3±51.3	37.2±4.9	1（2.2）
t/χ²值			-1.256	0.893	1.243	<0.001
P值			0.157	0.125	0.114	1.151
组别	例数	腹部手术史[例（%）]	白细胞（×10⁹/L，±s）	血红蛋白（g/L，±s）	D-二聚体（mg/L，±s）	纤维蛋白原（g/L，±s）
实验组	40	4（10.0）	8.6±1.6	123.7±2.3	0.3±0.2	3.8±0.8
对照组	46	3（6.5）	8.3±1.2	124.7±3.8	0.2±0.1	3.2±0.8
t/χ²值		<0.001	-1.354	0.812	1.456	-2.354
P值		0.721	0.187	0.158	0.387	0.354

组别	例数	手术时间（min）	术后排气时间（h）	术后血红蛋白下降（g/L）	术中出血量（ml）	D-二聚体（mg/L）
实验组	40	68.0±23.0	20.0±5.0	3.0±2.0	20.0±8.0	0.4±0.2
对照组	46	75.0±28.0	25.0±8.0	8.0±3.0	24.0±5.0	0.2±0.1
t值		-3.643	-4.157	-5.433	-2.564	-1.823
P值		0.001	<0.001	<0.001	0.002	0.180
组别	例数	纤维蛋白原（g/L）	中性粒细胞百分比（%）	C反应蛋白（mg/L）	白细胞（×10⁹/L）	术后住院时间（d）
实验组	40	5.2±0.4	80.0±3.0	13.1±5.6	13.6±4.1	3.0±1.0
对照组	46	3.1±0.6	86.0±4.0	17.8±9.3	14.8±3.7	3.0±2.0
t值		-3.821	-3.657	-2.257	-2.451	-3.541
P值		0.150	<0.001	<0.001	0.506	0.638

组别	例数	手术时间（min）	术后排气时间（h）	术后血红蛋白下降（g/L）	术中出血量（ml）	D-二聚体（mg/L）
实验组	40	68.0±23.0	20.0±5.0	3.0±2.0	20.0±8.0	0.4±0.2
对照组	46	75.0±28.0	25.0±8.0	8.0±3.0	24.0±5.0	0.2±0.1
t值		-3.643	-4.157	-5.433	-2.564	-1.823
P值		0.001	<0.001	<0.001	0.002	0.180
组别	例数	纤维蛋白原（g/L）	中性粒细胞百分比（%）	C反应蛋白（mg/L）	白细胞（×10⁹/L）	术后住院时间（d）
实验组	40	5.2±0.4	80.0±3.0	13.1±5.6	13.6±4.1	3.0±1.0
对照组	46	3.1±0.6	86.0±4.0	17.8±9.3	14.8±3.7	3.0±2.0
t值		-3.821	-3.657	-2.257	-2.451	-3.541
P值		0.150	<0.001	<0.001	0.506	0.638

组别	例数	头晕	心悸	发热	心律失常	下肢深静脉血栓	总并发症
实验组	40	0（0.0）	0（0.0）	3（7.5）	0（0.0）	0（0.0）	3（7.5）
对照组	46	2（4.3）	1（2.2）	5（10.9）	1（2.2）	1（2.2）	10（21.7）
χ²值		-2.569	-5.312	-2.346	-2.924	-3.294	-2.584
P值		0.071	0.139	0.264	0.088	0.063	0.073

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