학술논문

Comparison of Laparoscopic Sleeve Gastrectomy Bleeding and Leakage Rates in Four Staple-Line Reinforcement Methods: A Prospective Observational Study.
Document Type
Journal Article
Source
Journal of Laparoendoscopic & Advanced Surgical Techniques. Nov2022, Vol. 32 Issue 11, p1176-1180. 5p.
Subject
*SLEEVE gastrectomy
*SURGICAL complications
*FIBRIN tissue adhesive
*LAPAROSCOPIC surgery
*LEAKAGE
*STAPLERS (Surgery)
*SUTURES
*MORBID obesity
*GASTRECTOMY
*LAPAROSCOPY
*HEMORRHAGE
*DISEASE complications
Language
ISSN
1092-6429
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. [ABSTRACT FROM AUTHOR]