The effect of oversewing the staple line in laparoscopic sleeve gastrectomy: randomized control trial.

Janik, Michał; Paśnik, Krzysztof; Stanowski, Edward

doi:10.5114/wiitm.2016.62801

Cited by 15 publications

(18 citation statements)

References 22 publications

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“…13 As a result, seven RCTs with high quality were included in our metaanalysis. [14][15][16][17][18][19][20]…”

Section: Resultsmentioning

confidence: 99%

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Staple line oversewing during laparoscopic sleeve gastrectomy

Wang

Feng

et al. 2017

annals

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Introduction This meta-analysis was performed to assess the possible benefits of staple line oversewing during laparoscopic sleeve gastrectomy. Methods A comprehensive search up to February 2017 was conducted on PubMed, the Web of Science™ and Embase™. All eligible studies were included, and the outcomes of staple line bleeding and leak, overall complications and operative time were pooled. Results A total of 7 randomised controlled trials involving 845 patients (428 cases and 417 controls) were analysed. There was no significant difference in staple line bleeding (relative risk [RR]: 0.858, 95% confidence interval [CI]: 0.343-2.143, p=0.742), leak (RR: 0.650, 95% CI: 0.257-1.644, p=0.363) or overall complications (RR: 0.913, 95% CI: 0.621-1.342, p=0.644) between the oversewing group and the patients who did not have oversewing. Oversewing of the staple line was associated with a longer operative time (weighted mean difference: 14.400, 95% CI: 7.198-21.602, p=0.000). Conclusions Oversewing the staple line during laparoscopic sleeve gastrectomy does not decrease the risk of staple line bleeding, leakage or overall complications but it does prolong the operative time.

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“…13 As a result, seven RCTs with high quality were included in our metaanalysis. [14][15][16][17][18][19][20]…”

Section: Resultsmentioning

confidence: 99%

“…Some limitations of this meta-analysis should be addressed. First, the use of blinding was not mentioned in five of the studies [14][15][16]18,20 and this lowered the methodological quality of those RCTs. Further high quality studies evaluating the efficacy of staple line oversewing in the future might change the results of a meta-analysis.…”

Section: Discussionmentioning

confidence: 99%

Staple line oversewing during laparoscopic sleeve gastrectomy

Wang

Feng

et al. 2017

annals

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“…The decision made on cartridge selection should be based on a universal protocol, which may be helpful in preventing potential lawsuits. Constant development of new methods for preventing gastric leaks, and controversies about oversewing of the staple line prove that studies of gastric wall biology from the perspective of bariatric surgery should be thoroughly analyzed [ 21 ]. It is especially important given that there are no clear guidelines on how to manage the leaks after sleeve gastrectomy, and the treatment outcomes are not always good [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

Gastric wall thickness and stapling in laparoscopic sleeve gastrectomy - a literature review.

Barski¹,

Binda²,

Kudlicka³

et al. 2018

Videosurgery and Other Miniinvasive Techniques

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Despite the growing experience of bariatric surgeons in performing laparoscopic sleeve gastrectomy, the number of complications involving staple line leaks remains constant. Hence a solution to avoid such complications is still sought. A defect of the staple line may be the consequence of an inappropriate choice of staple size in relation to gastric wall thickness. Due to the variable nature of gastric wall thickness, the choice of proper staple height is not obvious. In the few studies in which gastric wall thickness was measured, it was observed to decrease gradually from the antrum to the fundus. However, the authors are divided on the issue of whether gender and body mass index influence gastric wall thickness. The question whether there are other perioperative factors that would allow gastric wall thickness to be predicted remains unanswered.

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“…The resected part of the stomach was removed by one of the 12-mm ports. In some cases we reinforced the staple line with a running suture when there was bleeding which could not be stopped by clipping [ 8 ]. A blue dye solution test was performed in every case to detect possible intraoperative leakage.…”

Section: Methodsmentioning

confidence: 99%

Age is not associated with increased surgical complications in patients after laparoscopic sleeve gastrectomy.

Jędrzejewski¹,

Liszka²,

Maciejewski³

et al. 2017

Videosurgery and Other Miniinvasive Techniques

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Introduction Age is considered as a risk factor in bariatric surgery. The observation was made on the basis of results from studies where patients underwent different type of surgery, but laparoscopic sleeve gastrectomy (LSG) was not among them. It is necessary to reevaluate the association of age with adverse events in the group of patients after LSG. Aim To investigate the association of age with surgery-related adverse events in patients after LSG. Material and methods Retrospective analysis of medical data was performed. The study involved 345 patients who underwent LSG in our institution between January 2013 and December 2014. The patients were subdivided by age into four groups according to quartiles. In 30-day follow-up adverse events were evaluated. We considered the presence of the following events as the endpoint of our study: death, medical events and surgical events. Results In general, we observed adverse events in 36 (10.4%) patients. The mortality rate in our study was 0.59%. Nineteen events were surgical and 18 medical. In 1 patient a surgical event was associated with a medical event. Bleeding was the most common surgical event and was observed in 17 (4.9%) cases. Age was not associated with surgical events (OR = 1.032, 95% CI: 0.991–1.075, p = 0.33) or medical events (OR = 0.997, 95% CI: 0.956–1.039, p = 0.89). Conclusions The LSG is a safe bariatric procedure with low mortality. Bleeding is the most frequent surgical complication. Our findings suggest that age is not associated with increased risk of surgical or medical adverse events after LSG.

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The effect of oversewing the staple line in laparoscopic sleeve gastrectomy: randomized control trial.

Cited by 15 publications

References 22 publications

Staple line oversewing during laparoscopic sleeve gastrectomy

Staple line oversewing during laparoscopic sleeve gastrectomy

Gastric wall thickness and stapling in laparoscopic sleeve gastrectomy - a literature review.

Age is not associated with increased surgical complications in patients after laparoscopic sleeve gastrectomy.

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