Current role of staple line reinforcement in 30-day outcomes of primary laparoscopic sleeve gastrectomy: an analysis of MBSAQIP data, 2015–2016 PUF

Demeusy, Andrew; Sill, Anne; Averbach, Andrew

doi:10.1016/j.soard.2018.06.024

Cited by 39 publications

(14 citation statements)

References 25 publications

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“…Nevertheless, surgeons’ personal experience might play a vital role in decreasing and even preventing this undesirable complication 57 . In 2018, Demusy et al analyzed the nationwide data in the United States, which disclosed that the bougie size was not associated with postoperative leak rate, and the risk of bleeding and reoperation was decreased via concomitant staple line reinforcement intraoperatively 58 . In our network meta-analysis, overall complication rates or SLL did not significantly increase in the group with bougie size of < 32 Fr.…”

Section: Discussionmentioning

confidence: 99%

Promising effects of 33 to 36 Fr. bougie calibration for laparoscopic sleeve gastrectomy: a systematic review and network meta-analysis

Chang

Chen

Jhou

et al. 2021

Sci Rep

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The standard size of bougie for laparoscopic sleeve gastrectomy (LSG) is not yet established. Therefore, a systematic review and network meta-analysis were conducted to assess the weight loss effects and associated complications of LSG for patients with morbid obesity, based on different bougie sizes. A total of 15 studies were reviewed in this systemic review and network meta-analysis (2,848 participants), including RCTs and retrospective studies in PubMed, and Embase until September 1, 2020. The effectiveness of different bougie calibration sizes was assessed based on excess weight loss (EWL), total complications, and staple line leak. Within this network meta-analysis, S-sized (≤ 32 Fr.) and M-sized (33–36 Fr.) bougies had similar effects and were associated with the highest EWL improvement among all different bougie sizes (S-sized: standardized mean difference [SMD], 10.52; 95% confidence interval [CI] − 5.59 to − 26.63, surface under the cumulative ranking curve [SUCRA], 0.78; and M-sized: SMD, 10.16; 95% CI − 3.04–23.37; SUCRA, 0.75). M-sized bougie was associated with the lowest incidence of total complications (M-sized: odds ratio, 0.43; 95% CI, 0.16–1.11; SUCRA, 0.92). Based on our network meta-analysis, using M-sized bougie (33–36 Fr.) is an optimal choice to balance the effectiveness and perioperative safety of LSG in the clinical practice.

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Section: Discussionmentioning

confidence: 99%

Promising effects of 33 to 36 Fr. bougie calibration for laparoscopic sleeve gastrectomy: a systematic review and network meta-analysis

Chang

Chen

Jhou

et al. 2021

Sci Rep

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“…On the other hand, data from the MBSAQIP 2015-2016 Participant User File did not show any significant difference between the incidences of post-SG leaks with or without the use of staple line reinforcements 12,14 . Nevertheless, despite not being statistically significant, the overall leak rate after SG with staple line oversewing isolated was slightly lower than that reported after the procedure without any reinforcement techniques (0.3%x0.4%) 14 .…”

Section: Discussionmentioning

confidence: 80%

The Routine Use of the Methylene Blue Test in Sleeve Gastrectomy: Why Not?

Ferraz

Santa‐Cruz

BELFORT

et al. 2021

ABCD, arq. bras. cir. dig.

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Background: Although considered a safe procedure, sleeve gastrectomy (SG) has a non-negligible risk of major postoperative complications related to it, with special attention to gastric leaks. Aim: Evaluate the clinical value of the methylene blue test (MBT) in predicting the occurrence of post-SG leaks. Methods: Retrospective study that included 1136 patients who underwent SG with intraoperative MBT between 2012 and 2016. Sensitivity, specificity, positive predictive value (PPV) and negative predicted value (NPV) were calculated to determine the clinical correlation between the MBT and the occurrence of postoperative leaks. Staple line oversewing was performed in all patients who presented positive MBT. Results: Laparoscopic SG was performed in 97.0% of cases; open in 2.3%, and robotic in 0.7%. MBT was positive in 19 cases (1.67%). One positive MBT occurred during an open SG and the other 18 at laparoscopy. Moreover, there were nine cases (0.8%) of postoperative leaks, among which, only two presented positive MBT. MBT diagnostic value was evaluated through the calculation of sensitivity (22.0%), specificity (98.0%), PPV (11.0%) and NPV (99.0%). There were no cases of allergic reaction or any other side effect with the use of the methylene blue solution. Conclusion: MBT showed high specificity and negative predictive value, thus presenting an important value to rule out the occurrence of postoperative leaks.

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“…No consensus has been reached in the literature on the efficacy of SLR after sleeve gastrectomy in preventing leaks [ 26 ]. For example Demeusy et al in his analysis of total 198339 primary LSG and the relationship between various SLR techniques demonstrated that SLR is associated with decreased rates of bleeding and reoperations but does not affect leak rates [ 27 ]. On the other hand, Gagner et al in his systematic review of staple-line leaks following LSG demonstrated a significantly lower rate using APM (absorbable polymer membrane) staple-line reinforcement as compared to oversewing, use of sealants, BPS reinforcement, or no reinforcement [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic Sleeve Gastrectomy with Omentopexy: Is It Really a Promising Method?—A Systematic Review with Meta-analysis

et al. 2021

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Purpose Laparoscopic sleeve gastrectomy (LSG) is one of the most commonly performed bariatric procedure worldwide. Omentopexy during LSG is a novel variation of this well-established technique. There are no clear conclusions on indications for this procedure, safeness, and effects of such a method. We aimed to compare the outcomes of laparoscopic sleeve gastrectomy (LSG) with omentopexy (OP) and without omentopexy. Materials and Methods We searched the Medline, EMBASE, and Scopus databases up-to June 2020. Full-text articles and conference abstracts were included for further analysis. This review follows the PRISMA guidelines. Results Of initial 66 records, only 4 studies (N = 1396 patients) were included in the meta-analysis. Our findings showed that LSG with omentopexy had significantly lowered overall morbidity compared to LSG without omentopexy (RR = 0.38; 95% CI [0.15, 0.94]; p=0.04). Gastric leakage rate (RR = 0.17; 95% CI [0.04, 0.76]; p = 0.02) was also significantly lower in LSG with omentopexy. There were no significant differences between groups in length of hospital stay. Conclusions Our meta-analysis showed that LSG with omentopexy may be a feasible procedure for decreasing morbidity and gastric leak rate. However, despite promising results, the procedure needs to be researched more in randomized controlled studies to draw solid conclusions.

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Current role of staple line reinforcement in 30-day outcomes of primary laparoscopic sleeve gastrectomy: an analysis of MBSAQIP data, 2015–2016 PUF

Cited by 39 publications

References 25 publications

Promising effects of 33 to 36 Fr. bougie calibration for laparoscopic sleeve gastrectomy: a systematic review and network meta-analysis

Promising effects of 33 to 36 Fr. bougie calibration for laparoscopic sleeve gastrectomy: a systematic review and network meta-analysis

The Routine Use of the Methylene Blue Test in Sleeve Gastrectomy: Why Not?

Laparoscopic Sleeve Gastrectomy with Omentopexy: Is It Really a Promising Method?—A Systematic Review with Meta-analysis

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