Retrospective Study
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Surg Proced. Nov 28, 2015; 5(3): 223-228
Published online Nov 28, 2015. doi: 10.5412/wjsp.v5.i3.223
Are stapler line reinforcement materials necessary in sleeve gastrectomy?
Ibrahim Sakcak
Ibrahim Sakcak, Department of General Surgery, Medicalpark Hospital, 06100 Ankara, Turkey
Ibrahim Sakcak, Department of General Surgery, Numune Education and Research Hospital, Sıhhiye, 06100 Ankara, Turkey
Author contributions: Sakcak I solely wrote this paper.
Institutional review board statement: Ethics committee approval is not obligatory in Turkey for retrospective studies (Clinical Study Regulation, Turkish Official Gazette, Date: April 13, 2013, No: 28617), therefore ethics committee approval was not obtained.
Informed consent statement: All patients provided their informed consent for surgery (informed consent could not be obtained for study due to its retrospective nature).
Conflict-of-interest statement: None.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at ibrahimsakcak66@gmail.com. Consent was not obtained but the presented data are anonymized and risk of identification is low.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Ibrahim Sakcak, Associate Professor, Department of General Surgery, Medicalpark Hospital, Sihhiye, 06100 Ankara, Turkey. ibrahimsakcak66@gmail.com
Telephone: +90-312-6668000 Fax: +90-212-2273477
Received: May 5, 2015
Peer-review started: May 6, 2015
First decision: May 13, 2015
Revised: May 28, 2015
Accepted: July 16, 2015
Article in press: July 17, 2015
Published online: November 28, 2015
Processing time: 204 Days and 10.7 Hours
Abstract

AIM: To investigate the effect of staple line reinforcement materials on decreasing complications related to sleeve gastrectomy.

METHODS: In this retrospective study, we analyzed 84 patients who had sleeve gastrectomy due to obesity between April 2012 and April 2015. Sleeve gastrectomy procedure was performed in patients with a body mass index (BMI) more than 40 kg/m2, and the ones with a BMI between 32 and 40 kg/m2 in the presence of comorbid diseases. Reinforcement materials were used in 45 patients while they were not used in 39 patients. Materials such as Peristrip, 3/0 prolene, and V-lock were used for reinforcement in the reinforcement group (RG), and the materials used showed variations during the study period. The baseline characteristics, duration of surgery, hospital stay, comorbidities including hypertension, type 2 diabetes mellitus, hypertension, hepatosteatosis, gallstones, osteoarthritis, gastroesophageal reflux, sleep disorders, as well as the complications including leaks and bleeding after surgery were recorded and compared between the reinforcement and non-RGs (NRGs).

RESULTS: There were no differences between the reinforcement and NRGs for baseline characteristics including age (P = 0.689), gender (P = 0.057), height (P = 0.483), weight (P = 0.889), BMI (P = 0.971), hospital stay (P = 0.888), or duration of surgery (P = 0.229). The most common comorbidities in the RG were hypertension (24.4%) and hepatosteatosis (24.4%), while type 2 diabetes mellitus (28.2%) and hepatosteatosis (28.2%) were the most frequent comorbidities in the NRG. There were no differences between the reinforcement and NRGs for the rates of comorbidities (P > 0.05). Leak was observed in one (2.2%) patient in the RG, and there was leak in 2 (5.1%), and bleeding in 2 (5.1%) patients in the NRG. There were no differences between the reinforcement and NRGs for the rate of staple line leaks (P = 0.446) or bleeding (P = 0.213). One of the patients with leak died in the NRG while there were no deaths in the RG.

CONCLUSION: Although staple line reinforcement materials decreased morbidity and mortality, the differences between the two groups were not statistically significant.

Keywords: Obesity; Sleeve gastrectomy; Staple line; Reinforcement

Core tip: Sleeve gastrectomy is one of the most frequently performed surgical procedures in the treatment of obesity. In this study, we investigated the efficiency of use of staple line reinforcement materials in decreasing these complications. We included 84 patients in our study. Reinforcement materials were used in 45 patients while they were not used in 39 patients. Although we found that staple line reinforcement materials decreased morbidity and mortality, the differences between the two groups were not statistically significant for complications or mortality. There is a need for prospective randomized studies on larger patient populations to further clarify the subject.