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- Title
Comparison of Laparoscopic Sleeve Gastrectomy Bleeding and Leakage Rates in Four Staple-Line Reinforcement Methods: A Prospective Observational Study.
- Authors
Di Capua, Francesco; Cesana, Giovanni Carlo; Uccelli, Matteo; Ciccarese, Francesca; Olmi, Stefano
- Abstract
Introduction: Staple-line bleeding and gastric leakage are the most serious complications of laparoscopic sleeve gastrectomy (LSG). Reinforcement of the staple line is reported to be a method to reduce these complications rates, but the question of which method is preferable is a matter of controversy in the literature. In this study, we compared different staple-line reinforcement methods to assess their efficiency in preventing staple-line bleeding and leakage. Materials and Methods: Two hundred patients eligible for LSG were enrolled in the study and randomized into five groups based on the reinforcement method used during surgery: no reinforcement, oversewing using 3-0 polydioxanone (PDS) suture, oversewing using 4-0 barbed absorbable closure device (V-Lock), fibrin sealant glue, and buttress material. Intraoperative and postoperative complications were recorded and analyzed. Differences were considered statistically significant for P < .05. Results: The no-reinforcement group showed higher bleeding rates (20%), although only 2.5% of the patients required reintervention. All groups using staple-line reinforcement showed better outcomes in bleeding rates (P < .05). No statistically significant differences were observed among the groups in terms of the leakage rate, reintervention rate, intraoperative complications, and operative times. Conclusion: The reinforcement of the staple line decreased the bleeding rate in sleeve gastrectomy but did not affect the gastric leakage rate.
- Subjects
SLEEVE gastrectomy; SURGICAL complications; FIBRIN tissue adhesive; LAPAROSCOPIC surgery; LEAKAGE; STAPLERS (Surgery); SUTURES; MORBID obesity; GASTRECTOMY; LAPAROSCOPY; HEMORRHAGE; DISEASE complications
- Publication
Journal of Laparoendoscopic & Advanced Surgical Techniques, 2022, Vol 32, Issue 11, p1176
- ISSN
1092-6429
- Publication type
journal article
- DOI
10.1089/lap.2022.0122