| Autor: |
Zarzycki P; Department of Medical Education, Jagiellonian University Medical College, 30-688 Krakow, Poland., Rymarowicz J; 2nd Department of General Surgery, Jagiellonian University Medical College, 30-688 Krakow, Poland., Małczak P; 2nd Department of General Surgery, Jagiellonian University Medical College, 30-688 Krakow, Poland., Pisarska-Adamczyk M; Department of Medical Education, Jagiellonian University Medical College, 30-688 Krakow, Poland., Mulek R; EuroMediCare Specialist Hospital and Clinic, 54-144 Wroclaw, Poland., Binda A; Department of General, Oncological and Digestive Tract Surgery, Centre of Postgraduate Medical Education, Orłowski Hospital, 00-416 Warsaw, Poland., Dowgiałło-Gornowicz N; Department of General, Minimally Invasive and Elderly Surgery, Collegium Medicum, University of Warmia and Mazury, 10-045 Olsztyn, Poland., Major P; 2nd Department of General Surgery, Jagiellonian University Medical College, 30-688 Krakow, Poland., Pross Collaborative Study Group |
| Abstrakt: |
Background and Objectives: Although the technical simplicity of laparoscopic sleeve gastrectomy is relatively well understood, many parts of the procedure differ according to bariatric surgeons. These technical variations may impact postoperative weight loss or the treatment of comorbidities and lead to qualification for redo procedures. Materials and Methods : A multicenter, observational, retrospective study was conducted among patients undergoing revision procedures. Patients were divided into three groups based on the indications for revisional surgery (insufficient weight loss or obesity-related comorbidities treatment, weight regain and development of complications). Results : The median bougie size was 36 (32-40) with significant difference ( p = 0.04). In 246 (51.57%) patients, the resection part of sleeve gastrectomy was started 4 cm from the pylorus without significant difference ( p = 0.065). The number of stapler cartridges used during the SG procedure was six staplers in group C ( p = 0.529). The number of procedures in which the staple line was reinforced was the highest in group A (29.63%) with a significant difference (0.002). Cruroplasty was performed in 13 patients ( p = 0.549). Conclusions : There were no differences between indications to redo surgery in terms of primary surgery parameters such as the number of staplers used or the length from the pylorus to begin resection. The bougie size was smaller in the group of patients with weight regain. Patients who had revision for insufficient weight loss were significantly more likely to have had their staple line oversewn. A potential cause could be a difference in the size of the removed portion of the stomach, but it is difficult to draw unequivocal conclusions within the limitations of our study. |
