Musella Mario, Milone Marco, Bellini Marcello, Leongito Maddalena, Guarino Roberto, Milone Francesco
Department of Surgery, Orthopedy, Traumatology and Emergency, University of Naples "Federico II' Naples, Italy.
Ann Ital Chir. 2011 Jul-Aug;82(4):273-7.
The aim of this study is to compare the material effectiveness of oversewing the staple line following laparoscopic sleeve gastrectomy.
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.
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).
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.
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.
本研究旨在比较腹腔镜袖状胃切除术后缝合吻合钉线的实际效果。
对100例连续接受腹腔镜袖状胃切除术的患者进行了一项前瞻性随机试验。在干预前，患者被随机分为接受（A组）或不接受（B组）用3-0聚丙烯缝线连续缝合吻合钉线。
通过评估A组和B组术前的一般人口统计学特征和合并症，未观察到统计学差异。评估的主要并发症为瘘、出血和狭窄，瘘的发生率（p = 0.55）和出血（p = 0.65）无显著差异，另一方面，必须指出的是，进行缝合时袖状狭窄明显更高（p = 0.04）。
吻合钉线渗漏是腹腔镜袖状胃切除术（LSG）令人担忧的并发症。尽管一些报告将缝合吻合钉线描述为预防此类问题的解决方案；但其他作者表明，缝合和未缝合患者的渗漏发生率相同。
到目前为止，这项随机试验表明，根据我们的研究设计选择的患者，腹腔镜袖状胃切除术的缝合对预防瘘的形成明显无效。
