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Partial staple line reinforcement with synthetic buttressing material in laparoscopic sleeve gastrectomy: a propensity score-matched analysis

PURPOSE: Staple line leakage (SLL) and staple line bleeding (SLB) are the most relevant postoperative complications of sleeve gastrectomy (SG). It is controversial whether and which method of staple line reinforcement (SLR) can best reduce these complications. The primary objective of this study was...

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Autores principales: Eckharter, Christoph, Heeren, Nickolaus, Mongelli, Francesco, Sykora, Martin, Mühlhäusser, Julia, Lottenbach, Nathalie, Scheiwiller, Andreas, Metzger, Jürg, Gass, Jörn-Markus
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9859840/
https://www.ncbi.nlm.nih.gov/pubmed/36662323
http://dx.doi.org/10.1007/s00423-023-02796-6
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author Eckharter, Christoph
Heeren, Nickolaus
Mongelli, Francesco
Sykora, Martin
Mühlhäusser, Julia
Lottenbach, Nathalie
Scheiwiller, Andreas
Metzger, Jürg
Gass, Jörn-Markus
author_facet Eckharter, Christoph
Heeren, Nickolaus
Mongelli, Francesco
Sykora, Martin
Mühlhäusser, Julia
Lottenbach, Nathalie
Scheiwiller, Andreas
Metzger, Jürg
Gass, Jörn-Markus
author_sort Eckharter, Christoph
collection PubMed
description PURPOSE: Staple line leakage (SLL) and staple line bleeding (SLB) are the most relevant postoperative complications of sleeve gastrectomy (SG). It is controversial whether and which method of staple line reinforcement (SLR) can best reduce these complications. The primary objective of this study was to investigate whether reinforcement of the most proximal part of the staple line with synthetic buttressing material, a strategy we termed partial SLR (p-SLR), reduces the 30-day incidence of SLL. METHODS: A retrospective search of medical records of all bariatric patients from 2010 to 2019 was performed. Patients who underwent SG with either p-SLR or non-SLR were included. Intraoperative and postoperative outcomes were analyzed before and after propensity score matching (PSM). RESULTS: Data from 431 patients were analyzed (364 in the p-SLR group and 67 in the non-SLR group). No difference in the 30-day incidence of SLL was observed between the two groups. The 30-day incidence of SLB (1.1% vs. 6.0% in the p-SLR and non-SLR groups, respectively) was significantly lower in the p-SLR group. These results were confirmed by PSM analysis. CONCLUSION: Partial staple line reinforcement with synthetic buttressing material does not reduce the 30-day incidence of SLL. Although our analysis showed a significant reduction in the 30-day incidence of SLB in the p-SLR group, this result should be interpreted with caution.
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spelling pubmed-98598402023-01-22 Partial staple line reinforcement with synthetic buttressing material in laparoscopic sleeve gastrectomy: a propensity score-matched analysis Eckharter, Christoph Heeren, Nickolaus Mongelli, Francesco Sykora, Martin Mühlhäusser, Julia Lottenbach, Nathalie Scheiwiller, Andreas Metzger, Jürg Gass, Jörn-Markus Langenbecks Arch Surg Research PURPOSE: Staple line leakage (SLL) and staple line bleeding (SLB) are the most relevant postoperative complications of sleeve gastrectomy (SG). It is controversial whether and which method of staple line reinforcement (SLR) can best reduce these complications. The primary objective of this study was to investigate whether reinforcement of the most proximal part of the staple line with synthetic buttressing material, a strategy we termed partial SLR (p-SLR), reduces the 30-day incidence of SLL. METHODS: A retrospective search of medical records of all bariatric patients from 2010 to 2019 was performed. Patients who underwent SG with either p-SLR or non-SLR were included. Intraoperative and postoperative outcomes were analyzed before and after propensity score matching (PSM). RESULTS: Data from 431 patients were analyzed (364 in the p-SLR group and 67 in the non-SLR group). No difference in the 30-day incidence of SLL was observed between the two groups. The 30-day incidence of SLB (1.1% vs. 6.0% in the p-SLR and non-SLR groups, respectively) was significantly lower in the p-SLR group. These results were confirmed by PSM analysis. CONCLUSION: Partial staple line reinforcement with synthetic buttressing material does not reduce the 30-day incidence of SLL. Although our analysis showed a significant reduction in the 30-day incidence of SLB in the p-SLR group, this result should be interpreted with caution. Springer Berlin Heidelberg 2023-01-20 2023 /pmc/articles/PMC9859840/ /pubmed/36662323 http://dx.doi.org/10.1007/s00423-023-02796-6 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Research
Eckharter, Christoph
Heeren, Nickolaus
Mongelli, Francesco
Sykora, Martin
Mühlhäusser, Julia
Lottenbach, Nathalie
Scheiwiller, Andreas
Metzger, Jürg
Gass, Jörn-Markus
Partial staple line reinforcement with synthetic buttressing material in laparoscopic sleeve gastrectomy: a propensity score-matched analysis
title Partial staple line reinforcement with synthetic buttressing material in laparoscopic sleeve gastrectomy: a propensity score-matched analysis
title_full Partial staple line reinforcement with synthetic buttressing material in laparoscopic sleeve gastrectomy: a propensity score-matched analysis
title_fullStr Partial staple line reinforcement with synthetic buttressing material in laparoscopic sleeve gastrectomy: a propensity score-matched analysis
title_full_unstemmed Partial staple line reinforcement with synthetic buttressing material in laparoscopic sleeve gastrectomy: a propensity score-matched analysis
title_short Partial staple line reinforcement with synthetic buttressing material in laparoscopic sleeve gastrectomy: a propensity score-matched analysis
title_sort partial staple line reinforcement with synthetic buttressing material in laparoscopic sleeve gastrectomy: a propensity score-matched analysis
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9859840/
https://www.ncbi.nlm.nih.gov/pubmed/36662323
http://dx.doi.org/10.1007/s00423-023-02796-6
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