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Year : 2019  |  Volume : 3  |  Issue : 3  |  Page : 668-674

Evaluation of laparoscopic sleeve gastrectomy with and without staple line reinforcement

Department of General Surgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/sjamf.sjamf_80_19

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Background Laparoscopic sleeve gastrectomy (LSG) as a primarily restrictive bariatric surgical procedure has been shown to be effective in producing marked weight loss. However, LSG-associated gastric leakage and hemorrhages remain the most important challenges postoperatively. Staple line buttress reinforcement has been suggested to reduce these postoperative complications. Aim of the study The objective of this study was to evaluate laparoscopic sleeve gastrectomy with and without staple line reinforcement. Methods Between July 2017 and December 2018. 60 cases were prospectively and randomly enrolled in the two different techniques of handling the staple line during LSG. Group A I(30 patients) with no reinforcement. Group B(30 patients) with reinforcement by over sewing prolyn suture. Operative and postoperative complications were recorded. The study was controlled prospectively. Results Two patients develop leakage one in each group (3.3%). Two patients developed postoperative hemorrhage in Group A (6.6%), One case developed port site bleeding in Group B (3.3%). One patient developed sub phrenic abscess in group A (3.3%). Three patients readmitted for blood transfusion. Two patients re-operated for diagnostic laparoscopy, port site bleeding in group B (3.3%) and staple line bleeding in group A (3.3%). The differences between the two groups did not reach statistical significance. Conclusion In this prospective study the final results of leaving the staple line untouched appears to be safe, although the logic of reinforcement is understandable. However, improved results for reinforcement have not been supported by the statistics.

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