| Autor: |
Muir, Kathryn, Rice, William, Muir, Kathryn B, Rice, William V |
| Předmět: |
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| Zdroj: |
Surgical Endoscopy & Other Interventional Techniques; May2016, Vol. 30 Issue 5, p2043-2048, 6p, 1 Chart, 3 Graphs |
| Abstrakt: |
Background: Laparoscopic sleeve gastrectomy (LSG) has become a primary stand-alone procedure for weight-loss surgery. The standard technique for LSG involves several small abdominal incisions. The single port instrument delivery extended reach (SPIDER(®)) surgical system has been introduced as a single site modality. This technique has been described previously; however, weight-loss outcomes of SPIDER(®) sleeve gastrectomy have not been compared to multi-port LSG.Methods: We performed a retrospective review of a prospectively collected database. All cases were performed by a single surgeon between August 2011 and September 2013. Thirty-two patients underwent SPIDER(®) sleeve gastrectomy, while 30 underwent LSG. Primary outcomes were change in BMI and percent excess weight loss (%EWL) at 6 months post-operatively. Secondary outcomes included: operative time, estimated blood loss (EBL), and complications.Results: There were no demographic differences between cohorts except initial BMI (SPIDER(®) = 42.1, LSG = 46.5, p < 0.001). Mean %EWL at 6 months post-operatively was higher in the SPIDER(®) cohort (59.1 vs. 48.3 %, p < 0.005). Similarly there was a lower mean BMI at 6 months post-operatively in the SPIDER(®) cohort (31.1 vs. 35.5, p < 0.0001). The net change in BMI for each cohort was equivalent (SPIDER(®) = 11.1, LSG = 11.0, p = 0.95). Mean operative time was longer in SPIDER(®) cases (104.6 vs. 90.7 min, p < 0.02), while EBL was equivalent (32.1 vs. 34.3 mL, p = 0.56). There was one post-operative hemorrhage requiring laparoscopic clot evacuation in the SPIDER(®) cohort, and one wound infection in the LSG cohort.Conclusions: SPIDER(®) sleeve gastrectomy is not inferior to LSG with regard to decrease in BMI and %EWL at 6-months post-operatively. The higher %EWL observed in the SPIDER(®) cohort is likely due to patient selection bias. This study demonstrates that the SPIDER(®) technique is a viable alternative to LSG with similar weight-loss outcomes. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
| Externí odkaz: |
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