Department of Surgery, St Luke's University Hospital and Health Network, 1736 Hamilton Street, Allentown, PA, 18104, USA.
St Luke's University Hospital and Health Network-Research Institute, 801 Ostrum Street, Bethlehem, PA, 18015, USA.
Obes Surg. 2023 Sep;33(9):2662-2670. doi: 10.1007/s11695-023-06740-x. Epub 2023 Jul 29.
The objective of this study is to evaluate the outcomes for Staple Line Reinforcement (SLR) in RA-SG based on the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) database for 2019.
We selected patients who underwent RA-SG in the MBSAQIP PUF (Public Utility File) for the year 2019 and grouped them based on their SLR status: Oversewing (OS), Buttressing (BR), both OS and BR and neither. Our primary outcomes were bleeding, organ space infection (OSI), and adverse events (AEs), and our secondary outcomes were operation length, hospital length of stay, readmissions, and conversion to open rates. We conducted separate chi square or one-way analysis of variance (ANOVA) as appropriate and multivariable direct logistic regression models for the categorical outcomes.
We found 115,621 patients with complete data of which there were 16,494 who underwent RA-SG. Our results did not show a statistically significant decrease in incidence of postoperative bleeding for BR and OS (Adjusted OR = 0.782, p = 0.2291 and Adjusted OR of 0.482, p = 0.054 for BR and OS respectively). There was a statistically significant effect for SLR status on operation length, with OS patients having the highest operative times (log-transformed mean = 2.03), followed by both BR + OS patients (log-transformed mean = 1.99). BR patients had the shortest operation length.
SLR did not result in any significant differences related to bleeding, OSI or AEs following RA-SG according to MBSAQIP for the year 2019. However, OS resulted in significantly longer operative time compared to BR alone.
本研究旨在根据 2019 年代谢和减重手术认证和质量改进计划（MBSAQIP）数据库评估 RA-SG 中使用缝线加固（SLR）的结果。
我们从 MBSAQIP PUF（公共实用程序文件）中选择了 2019 年接受 RA-SG 的患者，并根据他们的 SLR 状态将其分组：缝合（OS）、加固（BR）、OS 和 BR 以及两者都没有。我们的主要结果是出血、器官间隙感染（OSI）和不良事件（AE），次要结果是手术时间、住院时间、再入院和转为开放的比率。我们分别进行了适当的卡方检验或单因素方差分析（ANOVA），以及多变量直接逻辑回归模型分析分类结果。
我们发现了 115621 名有完整数据的患者，其中有 16494 名患者接受了 RA-SG。BR 和 OS 并没有显示出术后出血发生率的统计学显著降低（调整后的 OR=0.782，p=0.2291 和调整后的 OR 分别为 0.482，p=0.054）。SLR 状态对手术时间有统计学显著影响，OS 患者的手术时间最长（对数转换平均值=2.03），其次是 BR+OS 患者（对数转换平均值=1.99）。BR 患者的手术时间最短。
根据 2019 年 MBSAQIP，SLR 并没有导致 RA-SG 后出血、OSI 或 AE 出现任何显著差异。然而，与单独 BR 相比，OS 导致手术时间显著延长。
