Laparoscopic sleeve gastrectomy with 27 versus 39 Fr bougie calibration: a randomized controlled trial

Cal, Patricio; Deluca, Luciano; Jakob, Tomás; Fernández, Ezequiel

doi:10.1007/s00464-015-4450-0

Cited by 38 publications

(17 citation statements)

References 12 publications

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“…Eight studies (2168 patients; 4 treatment nodes) were found to investigate EWL with different bougie sizes after LSG in the current NMA (the network structure figure is shown in Fig. 2 A) 14 , 18 – 21 , 23 , 24 , 26 . Figure 3 A presents results of EWL percentage.…”

Section: Resultsmentioning

confidence: 99%

“…Although several systemic meta-analyzes, based on pooled data from case series and randomized controlled trials (RCTs), have been published, the standard bougie size for LSG is not yet established 16 , 17 , 21 , 23 – 28 . Herein, we performed a network meta-analysis and cataloged results of these controlled trials into a comprehensive systematic review and meta-analysis of available data to determine the standard bougie size for calibration during LSG, based on excess weight loss (EWL), associated complications, and SLL percentage.…”

Section: Introductionmentioning

confidence: 99%

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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: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

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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“…By contrast, Parikh et al ( 15 ) compared 40-Fr and 50-Fr bougies and reported no differences in weight loss. Cal et al ( 16 ) conducted the only randomized controlled trial that investigated the relationship between weight loss and bougie diameter in 126 patients who underwent LSG; the results showed that the use of different bougie diameters had no effect on EWL after LSG. Despite the contradicting findings in the literature, surgeons have increasingly used narrow bougies to decrease the risk of weight regain.…”

Section: Discussionmentioning

confidence: 99%

The Effects of Bougie Diameters on Tissue Oxygen Levels After Sleeve Gastrectomy: A Randomized Experimental Trial

et al. 2018

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Background:Staple-line leak is the most frightening complication of laparoscopic sleeve gastrectomy and several predisposing factors such as using improper staple sizes regardless of gastric wall thickness, narrower bougie diameter and ischemia of the staple line are asserted.Aims:To evaluate the effects of different bougie diameters on tissue oxygen partial pressure at the esophagogastric junction after sleeve gastrectomy.Study Design:A randomized and controlled animal experiment with 1:1:1:1 allocation ratio.Methods:Thirty-two male Wistar Albino rats were randomly divided into 4 groups of 8 each. While 12-Fr bougies were used in groups 1 and 3, 8-Fr bougies were used in groups 2 and 4. Fibrin sealant application was also carried out around the gastrectomy line after sleeve gastrectomy in groups 3 and 4. Burst pressure of gastrectomy line, tissue oxygen partial pressure and hydroxyproline levels at the esophagogastric junction were measured and compared among groups.Results:Mortality was detected in 2 out of 32 rats (6.25%) and one of them was in group 2 and the cause of this mortality was gastric leak. Gastric leak was detected in 2 out of 32 rats (6.25%). There was no significant difference in terms of burst pressures, tissue oxygen partial pressure and tissue hydroxyproline levels among the 4 groups.Conclusion:The use of narrower bougie along with fibrin sealant has not had a negative effect on tissue perfusion and wound healing.

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“…21,28 Current substance use is seen in less than 2% of candidates for bariatric surgery; an active disorder is a contraindication to bariatric surgery. 7,29 There is a strong relationship between obesity and quality of life. [30][31][32] Individuals often report significant difficulties with physical (walking, climbing stairs) and occupational functioning.…”

Section: Psychosocial Status Of Candidates For Bariatric Surgerymentioning

confidence: 99%

Multidisciplinary Assessment and Management of a Complex Patient Who Underwent Bariatric Surgery for Clinically Severe Obesity: A Case Report

Sarwer¹

2021

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Laparoscopic sleeve gastrectomy with 27 versus 39 Fr bougie calibration: a randomized controlled trial

Abstract: The use of different bougie diameters had no impact on the volume of resected stomach, morbidity or short-term weight loss after LSG, although a trend was seen toward better weight loss with the smaller bougie. A longer-lasting follow-up will be necessary to further assess differences.

Cited by 38 publications

References 12 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 Effects of Bougie Diameters on Tissue Oxygen Levels After Sleeve Gastrectomy: A Randomized Experimental Trial

Multidisciplinary Assessment and Management of a Complex Patient Who Underwent Bariatric Surgery for Clinically Severe Obesity: A Case Report

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