Weight-loss outcomes of SPIDER(®) sleeve gastrectomy at 6 months compared to traditional laparoscopic technique
| Autor: | William V. Rice, Kathryn B. Muir |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
Adult
Male Sleeve gastrectomy medicine.medical_specialty genetic structures Databases Factual medicine.medical_treatment Operative Time Blood Loss Surgical Bariatric Surgery 030209 endocrinology & metabolism complex mixtures Body Mass Index 03 medical and health sciences 0302 clinical medicine Weight loss Gastrectomy Weight Loss medicine Humans Laparoscopy Retrospective Studies medicine.diagnostic_test business.industry Retrospective cohort study Surgery Obesity Morbid Treatment Outcome Anesthesia Cohort 030211 gastroenterology & hepatology Female medicine.symptom business Body mass index Abdominal surgery |
| Zdroj: | Surgical endoscopy. 30(5) |
| ISSN: | 1432-2218 |
| Popis: | 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.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.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.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. |
| Databáze: | OpenAIRE |
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