Department of Surgery, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
Department of Surgery, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
Surg Obes Relat Dis. 2019 Mar;15(3):404-408. doi: 10.1016/j.soard.2019.01.017. Epub 2019 Jan 25.
The use of circular staplers with a low staple height is associated with a lower risk for complication when used to construct the gastroenterostomy in laparoscopic gastric bypass surgery. The influence of staple height on outcome when using linear staplers has not been studied.
To investigate the influence of staple height when constructing the gastric pouch and gastroenterostomy using a linear stapler in laparoscopic gastric bypass surgery.
Nationwide, Sweden.
A retrospective, register-based cohort study, including all primary laparoscopic gastric bypass surgical procedures in Sweden registered in the Scandinavian Obesity Surgery Registry from January 2010 until January 2017, where linear staplers were used to construct the gastric pouch and the gastroenterostomy. Low stapler heights (closed height ≤1.0 mm) were compared with higher stapler heights (closed height ≥1.5 mm). The main outcome was postoperative complication within 30 days of surgery.
Within the study period, 27,975 patients were identified from the Scandinavian Obesity Surgery Registry. A closed staple height ≥1.5 mm was associated with higher risk for postoperative complication within 30 days of surgery compared with lower staple height. The risk was greater when used to construct the gastric pouch (adjusted odd ratio 1.30, 95% confidence interval 1.17-1.44, P < .001) as well as when constructing the gastroenterostomy (adjusted odd ratio 1.32, 95% confidence interval 1.20-1.45, P < .001).
The use of low staple height for construction of the gastric pouch and gastroenterostomy in laparoscopic gastric bypass surgery was associated with lower complication rates.
在腹腔镜胃旁路手术中，使用低位吻合器构建胃肠吻合口可降低并发症风险。使用线性吻合器时，吻合器高度对结果的影响尚未得到研究。
研究在腹腔镜胃旁路手术中使用线性吻合器构建胃袋和胃肠吻合口时吻合器高度的影响。
全国范围，瑞典。
一项回顾性、基于注册的队列研究，纳入 2010 年 1 月至 2017 年 1 月期间在斯堪的纳维亚肥胖手术登记处注册的所有瑞典原发性腹腔镜胃旁路手术，其中使用线性吻合器构建胃袋和胃肠吻合口。将低位吻合器高度（闭合高度≤1.0mm）与高位吻合器高度（闭合高度≥1.5mm）进行比较。主要结局是手术 30 天内的术后并发症。
在研究期间，从斯堪的纳维亚肥胖手术登记处确定了 27975 例患者。与低位吻合器高度相比，高位吻合器高度（闭合高度≥1.5mm）与术后 30 天内发生并发症的风险增加相关。用于构建胃袋（调整后的优势比 1.30，95%置信区间 1.17-1.44，P<0.001）和构建胃肠吻合口（调整后的优势比 1.32，95%置信区间 1.20-1.45，P<0.001）时风险更大。
在腹腔镜胃旁路手术中，使用低位吻合器构建胃袋和胃肠吻合口与较低的并发症发生率相关。
