Calibrated Gastrojejunostomy in Gastric Bypass: It Is a Myth

Valezi, Antonio Carlos; Mali, Jorge; Menezes, Mariano A.; Sato, Rikiya

doi:10.1007/s11695-018-3198-8

Cited by 4 publications

(8 citation statements)

References 14 publications

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“…No significant difference in stoma size was seen when using 1.5 cm or 3.0 cm staple length, and they suggested, in line with our results, that the diameter of the stoma increases with time. 7 When we planned this study, one question was whether a circular stapled gastrojejunostomy with an initial width of 12 mm, that mimics the width of a vertical banded gastroplasty could accelerate early weight loss after gastric bypass. However, early in the study, it was obvious that the gastrojejunostomy performed with a circular stapler 21-mm was much wider at onset than the 12 mm we expected.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4][5][6] However, few have studied the actual diameter of the created anastomosis. 7 The gastrojejunal anastomosis can be stapled with either a circular (CSD) or a linear (LSD) stapling device. The method used is usually based on the surgeon's preference, [8][9][10][11] though regional tradition also seems to influence the choice.…”

Section: Introductionmentioning

confidence: 99%

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Linear and circular stapled gastrojejunal anastomoses in Roux‐en‐Y gastric bypass: stomal diameter at onset and at long‐term follow‐up

Campanello

Lindskog

Zilling

2022

ANZ Journal of Surgery

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Background: In the laparoscopic Roux-en-Y gastric bypass procedure, the gastrojejunal stoma is constructed with either a circular (CSD) or a linear stapling device (LSD). The diameter of the stoma following stapling with the 21 mm CSD is expected to be approximately 12 mm (diameter of the anvil). Measuring the stoma diameter after linear stapling is a little more complex since the remaining opening in the linear anastomosis is closed by hand. The aim of this prospective randomized study was to follow up on changes in the diameter of gastrojejunal stomata after laparoscopic Roux-en-Y gastric bypass using either a CSD or an LSD between that at construction and at a long-term follow-up of 12-72 months later. Methods: Twenty patients were randomly assigned to gastrojejunostomy with either a 21 mm CSD or a 45 mm LSD. Directly after completion of the surgery, the diameter of the gastrojejunal stoma was measured using a Fogarty occlusion catheter and again at follow-up 12-72 months later. Results: Five patients were lost for follow-up, and 15 patients remained. The mean diameter of the CSD stomata at construction was 19.3 AE 5.3 mm (mean AE SD) and increased to 26.4 AE 6.6 mm at follow-up after a mean of 46 months (P = 0.02). The corresponding figures for the LSD stomata were 26.2 AE 4.1 mm, increasing to 32.7 AE 3.0 mm also after a mean follow-up of 46 months (P = 0.03). Conclusions: The mean diameter of the circular stapled gastrojejunostomy stomata at construction was 20 mm, that is, considerably larger than the 12 mm expected. After a mean of 5 years, the mean diameter had increased by 37%. The mean diameter of the linear stapled stomata increased by 25%.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Linear and circular stapled gastrojejunal anastomoses in Roux‐en‐Y gastric bypass: stomal diameter at onset and at long‐term follow‐up

Campanello

Lindskog

Zilling

2022

ANZ Journal of Surgery

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“…They found that weight loss was significantly greater in those patients for whom a shorter staple line was used. 23 However, in a similar study by Valezi et al 24 a comparison between 15 and 30 mm linear staple lines was performed and no significant difference in weight loss outcomes 1 year following surgery were noted. Importantly the short follow up period of these studies limits the long-term generalizability of the results.…”

Section: Discussionmentioning

confidence: 95%

“…Although the data concerning the size of the gastrojejunostomy and subsequent weight loss outcomes is well documented in the setting of circular staplers, for linear staplers this is not the case. 23,24 Moreover, there are no consensus guidelines regarding which length linear stapler cartridge leads to the creation of the optimum stoma size.…”

mentioning

confidence: 99%

Gastrojejunostomy in Roux-En-Y Gastric Bypass for Morbid Obesity: Linear Stapler Length Does Not Affect Mid-term Outcomes

Tankel¹,

Ahmed²

2021

Surgical Laparoscopy, Endoscopy &Amp; Percutaneous Techniques

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Background: The purpose of this study was to compare whether different linear stapler lengths used to form the gastrojejunostomy during laparoscopic Roux-En-Y gastric bypass affects mid-term weight loss outcomes.Materials and Methods: A retrospective single center analysis was performed. Surgical technique was identical other than either a 35 or 45 mm linear stapler being used to form the gastrojejunostomy. Multivariate regression was used to assess the relationship between the different stapler lengths and weight loss outcomes 2 years following surgery.Results: Of the 97 patients identified, 67 (69.1%) were included in the study. There were 30 patients in the 35 mm group and 37 in the 45 mm group. The groups were comparable in terms of basic demographic data and preoperative weight characteristics. There was no significant difference in weight loss outcomes 2 years following surgery when comparing between the different linear stapler lengths. Conclusion:Thirty-five versus 45 mm linear stapler lengths does not affect mid-term weight loss outcomes.

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“…Embora falte consenso sobre a influência do diâmetro da anastomose cirúrgica na perda de peso primária [99][100][101] , existem fortes evidências de que, no subgrupo de pacientes com reganho, tamanhos maiores se correlacionem com recuperação ponderal mais acentuada. Abu Dayyeh et al 102 avaliaram 165 pacientes em pós-operatório tardio de DGYR referenciados para endoscopia digestiva alta.…”

Section: Fatores Anatômicos/cirúrgicosunclassified

Ensaio clínico randomizado do tratamento endoscópico do reganho de peso pós derivação gástrica em Y de Roux através da moldagem da anastomose gastrojejunal com plasma de argônio isolado versus plasma de argônio associado à sutura endoscópica

Brunaldi¹

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Calibrated Gastrojejunostomy in Gastric Bypass: It Is a Myth

Abstract: Calibrated anastomosis has no utility in increasing weight loss in gastric bypass.

Cited by 4 publications

References 14 publications

Linear and circular stapled gastrojejunal anastomoses in Roux‐en‐Y gastric bypass: stomal diameter at onset and at long‐term follow‐up

Linear and circular stapled gastrojejunal anastomoses in Roux‐en‐Y gastric bypass: stomal diameter at onset and at long‐term follow‐up

Gastrojejunostomy in Roux-En-Y Gastric Bypass for Morbid Obesity: Linear Stapler Length Does Not Affect Mid-term Outcomes

Ensaio clínico randomizado do tratamento endoscópico do reganho de peso pós derivação gástrica em Y de Roux através da moldagem da anastomose gastrojejunal com plasma de argônio isolado versus plasma de argônio associado à sutura endoscópica

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