Published online Nov 28, 2015. doi: 10.5412/wjsp.v5.i3.223
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
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.
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.