Khalayleh Harbi, Hallaj Ashraf, Shweiki Amir, Bar-Zakai Barak, Sapojnikov Shimon, Imam Ashraf, Khalaileh Abed
Department of Surgery, Kaplan Medical Center, Rehovot and the Hebrew University Medical School, Jerusalem, Israel.
The Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.
Obes Surg. 2025 Mar;35(3):895-901. doi: 10.1007/s11695-025-07728-5. Epub 2025 Feb 4.
Stapler line reinforcement during sleeve gastrectomy (LSG) was assessed thoroughly in the context of postoperative complications focusing on leakage and bleeding. However, the effect of stapler line reinforcement techniques on the short- and long-term weight loss is still unclear and lacking. We hypothesize that inverting of the stapler line by Lembert suturing could lead to further additional reduction of the remnant gastric volume and accordingly a more significant weight reduction.
Retrospective analysis of patients that underwent LSG (2012-2018) from the two university hospitals. The first hospital routinely performed oversewing with inversion of the stapler line (first group, Lembert suture), while the second university hospital performed LSG without stapler line oversewing and inversion, but routinely used VeraSeal glue (second group, non-Lembert); both groups were compared in terms of weight loss and complications.
Four hundred eighty and 550 patients underwent LSG in the first and second hospital, consequently. The mean BMI change and EBWL at 1, 3, and 5 years were better in the first group than in second group. The mean last follow-up BMI was significantly lower in Lembert group (29.8 ± 5.2kg/m) than in non-Lembert group (32.9 ± 6.7 kg/m), P = 0.001. The mean EBWL at last follow-up point was significantly better for the Lembert group as compared to non-Lembert group (73.7 ± 26.59 versus 57.12 ± 27.71, P = 0.001).
Lembert suture line oversewing and inversion in LSG is associated with noticeable improvement in weight loss outcomes at 1, 3, and 5 years and last follow-up compared to LSG with VeraSeal gluing.
在袖状胃切除术（LSG）中，针对吻合器缝线加固的评估主要围绕术后并发症展开，重点关注渗漏和出血情况。然而，吻合器缝线加固技术对短期和长期体重减轻的影响仍不明确且缺乏相关研究。我们推测，采用伦伯特缝合法翻转吻合器缝线可进一步额外减小残余胃容积，从而实现更显著的体重减轻。
对两家大学医院中接受LSG（2012 - 2018年）的患者进行回顾性分析。第一家医院常规采用翻转吻合器缝线的缝合方法（第一组，伦伯特缝合），而第二家大学医院进行的LSG未进行吻合器缝线缝合及翻转，但常规使用VeraSeal胶水（第二组，非伦伯特缝合）；对两组患者的体重减轻情况和并发症进行比较。
第一家医院和第二家医院分别有480例和550例患者接受了LSG。第一组在1年、3年和5年时的平均体重指数变化和额外体重减轻情况均优于第二组。伦伯特组的末次随访平均体重指数（29.8 ± 5.2kg/m²）显著低于非伦伯特组（32.9 ± 6.7 kg/m²），P = 0.001。与非伦伯特组相比，伦伯特组末次随访时的平均额外体重减轻情况明显更好（73.7 ± 26.59对57.12 ± 27.71，P = 0.001）。
与使用VeraSeal胶水进行LSG相比，LSG中采用伦伯特缝合法进行缝线缝合及翻转与1年、3年、5年及末次随访时体重减轻效果的显著改善相关。
