The Effects of Reinforcement Methods on Burst Pressure in Resected Sleeve Gastrectomy Specimens
| Autor: | Nurullah Bülbüller, Mani Habibi, Umut Rıza Gündüz, Rojbin Karakoyun, Hasan Calis, Osman Zekai Öner, Hakan Gülkesen |
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| Rok vydání: | 2015 |
| Předmět: |
Adult
Male Sleeve gastrectomy Leak medicine.medical_specialty medicine.medical_treatment Anastomotic Leak Young Adult Gastrectomy Surgical Stapling Pressure medicine Humans Obesity Retrospective Studies Laparoscopic sleeve gastrectomy Sutures business.industry Equipment Design Middle Aged Surgery Treatment Outcome Staple line Female Laparoscopy Complication business Burst pressure Continuous suture |
| Zdroj: | Journal of Laparoendoscopic & Advanced Surgical Techniques. 25:64-68 |
| ISSN: | 1557-9034 1092-6429 |
| DOI: | 10.1089/lap.2014.0408 |
| Popis: | Staple-line leak is a life-threatening complication of laparoscopic sleeve gastrectomy. Reinforcement materials have been reported to lower the risk of staple-line bleeding, but their effects on leak risk have not been elucidated. The aim of this study was to compare the effects of two supportive techniques on burst pressures in sleeved gastrectomy specimens.Thirty patients who underwent laparoscopic sleeve gastrectomy were evaluated. The resected sleeve gastrectomy specimens were categorized into three groups. Group 1 had no extra support in the staple line, Group 2 had oversewing with continuous suture on the staple line, and Group 3 had fibrin sealant (Tisseel(®); Baxter, Deerfield, IL) on the staple line. The end point was the first detectable leakage, at which point leak pressure and the anatomic site of leakage were recorded.Thirty sleeved gastrectomy specimens were included (each group included 10 specimens). There were no differences among group in terms of age, sex, and body mass index. The leak pressure was significantly higher (106±10.5 mm Hg) in Group 2 (P.01). Leaks occurred significantly more frequently in the staple line than in the staple junction points (P=.014).Oversewing the staple line with 3-0 Vicryl(®) (Ethicon, Somerville, NJ) suture significantly increased the strength of the staple line. Increases in intraluminal pressure are known to be one of the significant risks in leak etiology. Thus, we concluded that oversewing the staple line with 3-0 Vicryl suture can be beneficial in the prevention of leaks. However, further work is necessary in this area of research. |
| Databáze: | OpenAIRE |
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