The Impact of Staple Line Reinforcement Utilization on Bleeding and Leak Rates Following Sleeve Gastrectomy for Severe Obesity: a Propensity and Case-Control Matched Analysis

Overview

Journal Obes Surg

Date 2019 Apr 17

PMID 30989567

Citations 9

Authors

Matthew Cunningham-Hill

Michael Mazzei

Huaqing Zhao

Xiaoning Lu

Michael A Edwards

Affiliations

Soon will be listed here.

Abstract

Introduction: Staple line reinforcement (SLR) is a commonly used technique during laparoscopic sleeve gastrectomy (SG) for severe obesity. There remains controversy over the potential benefit or risk associated with SLR. There are currently no consensus recommendations about SLR use. Its use is surgeon-dependent and remains controversial.

Study Aim: To determine the impact of staple line reinforcement on staple line leak and bleeding rates after sleeve gastrectomy.

Methods: Using the Metabolic and Bariatric Surgery Quality Improvement Program Participant User File (MBSQIP-PUF) database, we identified patients who had a SG in 2015 and 2016. SLR utilization status was used to create two cohorts. An unmatched cohort analysis was performed, and the outcomes were compared. A propensity score and case-control matched cohort analysis were then performed, and the outcomes were compared. Statistical analysis was performed with SPSS and SAS.

Results: Of the 189,173 SG cases identified, SLR utilization was noted in 127,521 (67.4%). In the unmatched analysis, bleeding and reoperation were significantly higher in the cohort without SLR utilization. In both propensity score and case-control matched analysis, bleeding and reoperation remained significantly higher in the cohort without SLR utilization. There was no difference in mortality and staple line leak rates between the cohorts.

Conclusions: SLR significantly reduces bleeding and reoperation rates following SG and has no deleterious impact on staple line leak rate. While further prospective studies factoring in the SLR method and staple characteristics are needed, this large database analysis supports the use of routine SLR during SG to reduce the risk of perioperative bleeding and reoperation.

Citing Articles

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PMID: 38168716 DOI: 10.1007/s11695-023-07021-3.

Long-Term Results of Sleeve Gastrectomy and Roux-en-Y Gastric Bypass in Individuals Older Than 60 Years with Morbid Obesity.

Drai C, Chierici A, Schiavo L, Amor I, Schneider S, Iannelli A Obes Surg. 2023; 33(12):3850-3859.

PMID: 37840091 DOI: 10.1007/s11695-023-06851-5.

Battle of the buttress: 5-year propensity-matched analysis of staple-line reinforcement techniques from the MBSAQIP database.

Aboueisha M, Freeman M, Allotey J, Evans L, Caposole M, Tatum D Surg Endosc. 2022; 37(4):3090-3102.

PMID: 35927350 DOI: 10.1007/s00464-022-09452-y.

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Lech P, Michalik M, Waczynski K, Osowiecka K, Dowgiallo-Gornowicz N Langenbecks Arch Surg. 2022; 407(7):2733-2737.

PMID: 35920900 PMC: 9640392. DOI: 10.1007/s00423-022-02630-5.

Bioabsorbable Glycolide Copolymer is Effective in Reducing Staple Line Bleeding in Sleeve Gastrectomy.

Iannelli A, Chierici A, Castaldi A, Drai C, Schneck A Obes Surg. 2022; 32(8):2605-2610.

PMID: 35696051 DOI: 10.1007/s11695-022-06152-3.

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