Laparoscopic sleeve gastrectomy. Do we need to oversew the staple line? 2011

Mario Musella, and Marco Milone, and Marcello Bellini, and Maddalena Leongito, and Roberto Guarino, and Francesco Milone
Department of Surgery, Orthopedy, Traumatology and Emergency, University of Naples "Federico II' Naples, Italy.

OBJECTIVE The aim of this study is to compare the material effectiveness of oversewing the staple line following laparoscopic sleeve gastrectomy. METHODS A prospective randomized trial has been performed on 100 consecutive patients who underwent laparoscopic sleeve gastrectomy. Just before the intervention patients were randomized to receive (Group A) or not receive (Group B) a polypropylene 3-0 running oversewing suture of the staple line. RESULTS By evaluating preoperative general demographics features and co-morbidities between group A and group B no statistical difference was observed. Main complications evaluated were fistol, bleeding and stenosis and there were no significant difference in fistulas occurrence (p = 0.55) and bleeding (p = 0,65) while on the other hand it has to be remarked how sleeve stenosis has been significantly higher when oversew is performed (p = 0.04). CONCLUSIONS Staple line leakage is a worrisome complication of laparoscopic sleeve gastrectomy (LSG). Despite some reports describe oversewing of the staple line as the solution to prevent such problem; other authors have demonstrated the incidence of leaks being the same in oversewed and not oversewed patients. CONCLUSIONS This randomized trial has so far shown oversew of LSG to be significantly useless to prevent fistulas formation in patients selected according to our study design.

UI MeSH Term Description Entries
D008297 Male Males
D010535 Laparoscopy A procedure in which a laparoscope (LAPAROSCOPES) is inserted through a small incision near the navel to examine the abdominal and pelvic organs in the PERITONEAL CAVITY. If appropriate, biopsy or surgery can be performed during laparoscopy. Celioscopy,Laparoscopic Surgical Procedures,Peritoneoscopy,Surgical Procedures, Laparoscopic,Laparoscopic Assisted Surgery,Laparoscopic Surgery,Laparoscopic Surgical Procedure,Procedure, Laparoscopic Surgical,Procedures, Laparoscopic Surgical,Surgery, Laparoscopic,Surgical Procedure, Laparoscopic,Celioscopies,Laparoscopic Assisted Surgeries,Laparoscopic Surgeries,Laparoscopies,Peritoneoscopies,Surgeries, Laparoscopic,Surgeries, Laparoscopic Assisted,Surgery, Laparoscopic Assisted
D011446 Prospective Studies Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group. Prospective Study,Studies, Prospective,Study, Prospective
D005260 Female Females
D005743 Gastrectomy Excision of the whole (total gastrectomy) or part (subtotal gastrectomy, partial gastrectomy, gastric resection) of the stomach. (Dorland, 28th ed) Gastrectomies
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D013536 Suture Techniques Techniques for securing together the edges of a wound, with loops of thread or similar materials (SUTURES). Suture Technics,Suture Technic,Suture Technique,Technic, Suture,Technics, Suture,Technique, Suture,Techniques, Suture
D017792 Surgical Stapling A technique of closing incisions and wounds, or of joining and connecting tissues, in which staples are used as sutures. Stapling, Surgical,Staplings, Surgical,Surgical Staplings

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