Departments of Surgical Oncology.
Radiology, Medical Faculty Hospital, Firat University, Elaziğ, Turkey.
Surg Laparosc Endosc Percutan Tech. 2020 Sep 15;31(2):181-187. doi: 10.1097/SLE.0000000000000863.
The aim of this study was to evaluate the protective effects of staple line reinforcement with omentopexy during laparoscopic sleeve gastrectomy on postoperative complications.
A total of 3942 laparoscopic sleeve gastrectomy cases were included in the study. All the patients were divided into 3 groups: No reinforcement (NoSLR), staple line reinforcement with fibrin glue (SLR-FG), and staple line reinforcement with omentopexy (SLR-O). Demographic data and perioperative characteristics of the groups were analyzed retrospectively. Among these, age, sex, preoperative comorbidities, American Society of Anesthesiologists scores, body mass index, duration of operation, reoperation, complications, and Clavien-Dindo classification scores were recorded.
Age, sex, body mass index, comorbid diseases, American Society of Anesthesiologists, and Clavien-Dindo Classification scores were similar in all the groups. The overall complication rate was 3.0%. The overall minor and major complication rates were 1.7% and 1.3%, respectively. The mortality rate was 0.1% (4 patients). The most common postoperative complications were bleeding (0.9%) and leakage (0.5%). The incidence of leakage, bleeding, and twisted gastric sleeve rates were similar when compared between SLR-FG and NoSLR. In the SLR-O patients, the incidence of leakage, hemorrhage, and twist were significantly lower and the operation time was significantly longer when compared with the other groups.
The SLR-O technique, especially when performed by experienced surgeons, is a promising method for the prevention of postoperative leakage, bleeding, and twist complications with an acceptable increase in the duration of operation. Considering the limited effects of the SLR-FG technique, it was predicted that it would lose its popularity over time.
本研究旨在评估腹腔镜袖状胃切除术时使用网膜固定加强吻合口在预防术后并发症方面的保护作用。
共纳入 3942 例腹腔镜袖状胃切除术病例。所有患者分为 3 组：无加固组（NoSLR）、吻合口加固使用纤维蛋白胶组（SLR-FG）和吻合口加固使用网膜组（SLR-O）。回顾性分析各组的人口统计学数据和围手术期特征。其中记录了年龄、性别、术前合并症、美国麻醉医师协会评分、体重指数、手术时间、再次手术、并发症和 Clavien-Dindo 分类评分。
所有组的年龄、性别、体重指数、合并症、美国麻醉医师协会评分和 Clavien-Dindo 分类评分相似。总体并发症发生率为 3.0%。总体轻微和严重并发症发生率分别为 1.7%和 1.3%。死亡率为 0.1%（4 例）。最常见的术后并发症是出血（0.9%）和漏液（0.5%）。与 NoSLR 相比，SLR-FG 和 SLR-O 患者的漏液、出血和扭转胃袖发生率相似。在 SLR-O 患者中，与其他组相比，漏液、出血和扭转的发生率明显较低，手术时间明显较长。
SLR-O 技术，尤其是由经验丰富的外科医生实施时，是预防术后漏液、出血和扭转并发症的一种有前途的方法，手术时间可接受延长。考虑到 SLR-FG 技术的效果有限，预计随着时间的推移，它的受欢迎程度将会下降。
