Minakari Mohammad, Sebghatollahi Vahid, Namaki Majid
Isfahan University of Medical Sciences, Isfahan, Iran, Islamic Republic of.
Obes Surg. 2025 Jun 27. doi: 10.1007/s11695-025-08014-0.
Sleeve gastrectomy (SG) is effective for obesity treatment but can lead to complications like postoperative leaks and fistulas. Endoscopic interventions have become the preferred method of management due to their minimally invasive nature. This meta-analysis evaluates the success rates and complications of various endoscopic treatments for leaks post-SG.
A systematic review and meta-analysis following PRISMA 2020 guidelines included 58 studies with 18,685 patients. The databases searched included Scopus, Embase, PubMed, Google Scholar, Web of Science, and Cochrane from inception until February 2025 using related keywords based on search strategy. Data on demographics, intervention types, success rates, and complications were analyzed using R software.
Among 18,685 patients, 2896 developed postoperative leaks. The overall success rate of endoscopic interventions was 88% (95% CI: 85-91.1%; p < 0.0001). Stenting was the most common intervention (48.02%) with a success rate of 90.6% (95% CI: 87.7-93.6%). Endoscopic suturing had the highest success rate (91%; 95% CI: 78.2-100%), followed by endoscopic vacuum therapy (85.1%; 95% CI: 69.4-100%), internal drainage (84.5%; 95% CI: 81.6-87.6%), and over-the-scope clips (77.1%; 95% CI: 55.9-98.2%). The most common complications were stent migration (24.5%) and stenosis (5%). Sensitivity analyses confirmed robust results with no significant publication bias (p = 0.6335).
Endoscopic interventions are effective for managing postoperative leaks after sleeve gastrectomy. Stenting and suturing have the highest success rates, though complications like stent migration require attention.
袖状胃切除术（SG）对肥胖治疗有效，但可能导致术后渗漏和瘘等并发症。由于其微创性，内镜干预已成为首选的治疗方法。本荟萃分析评估了SG术后各种内镜治疗渗漏的成功率和并发症。
按照PRISMA 2020指南进行的系统评价和荟萃分析纳入了58项研究，共18,685例患者。检索的数据库包括Scopus、Embase、PubMed、谷歌学术、科学网和Cochrane，从数据库建立至2025年2月，使用基于检索策略的相关关键词进行检索。使用R软件分析人口统计学、干预类型、成功率和并发症的数据。
在18,685例患者中，2896例发生了术后渗漏。内镜干预的总体成功率为88%（95%CI：85 - 91.1%；p < 0.0001）。支架置入是最常见的干预措施（48.02%），成功率为90.6%（95%CI：87.7 - 93.6%）。内镜缝合成功率最高（91%；95%CI：78.2 - 100%），其次是内镜负压治疗（85.1%；95%CI：69.4 - 100%）、内引流（84.5%；95%CI：81.6 - 87.6%）和圈套夹（77.1%；95%CI：55.9 - 98.2%）。最常见的并发症是支架移位（24.5%）和狭窄（5%）。敏感性分析证实结果可靠，无明显发表偏倚（p = 0.6335）。
内镜干预对袖状胃切除术后的术后渗漏管理有效。支架置入和缝合成功率最高，不过像支架移位这样的并发症需要引起关注。
