Home > Riviste > Minerva Surgery > Fascicoli precedenti > Minerva Surgery 2021 February;76(1) > Minerva Surgery 2021 February;76(1):43-9

ULTIMO FASCICOLO
 

JOURNAL TOOLS

eTOC
Per abbonarsi
Sottometti un articolo
Segnala alla tua biblioteca
 

ARTICLE TOOLS

Publication history
Estratti
Permessi
Per citare questo articolo
Share

 

ORIGINAL ARTICLE  TECHNICAL CHALLENGE IN BARIATRIC SURGERY 

Minerva Surgery 2021 February;76(1):43-9

DOI: 10.23736/S2724-5691.20.08505-3

Copyright © 2020 EDIZIONI MINERVA MEDICA

lingua: Inglese

The impact of the surgical technique on stenosis after laparoscopic sleeve gastrectomy

Pietro TERMINE 1, 2, Cristian E. BORU 2 , Florin TURCU 1, Catalin COPAESCU 1

1 Bariatric Center of Excellence IFSO EAC-EC, Ponderas Academic Hospital, Bucharest, Romania; 2 Division of General Surgery and Bariatric Center of Excellence-IFSO EC, Sapienza University of Rome, Rome, Italy



BACKGROUND: Laparoscopic sleeve gastrectomy (LSG) has gained worldwide popularity in the last 10 years as self alone bariatric procedure. Symptomatic stenosis (SS) is a potential severe postoperative complication and it can be divided in organic stenosis (OS) and functional stenosis (FS). The aim of this paper is to propose a modified surgical technique to prevent FS.
METHODS: A retrospective review on 5235 LSG performed in Ponderas Academic Hospital between January 2011 and December 2019, searched FS in two consecutive patients groups, divided based on the modified surgical technique introduced in 2015, with fixation of the gastric tube to the prepancreatic fascia and stapler line’s over-sewn running suture.
RESULTS: Group A (2011-2014) included 1332 LSG, 16 SS were registered (1.2%), 7 OS and 9 FS; 3903 LSG included in group B (2015-2019), counting for 37 SS (0.95%), 27 OS and 10 FS. A statistically significant difference between the 2 groups was observed for the FS incidence (P=0.03), while it was non-significant for the OS (P=0.52) and the total number of SS (P=0.43). The endoscopic approach was used in forty-eight SS (90.5%) with a successful rate of 83%, while specifically for the FS it was 100%; only one complication was registered during endoscopic treatment, that required further surgical solution.
CONCLUSIONS: Fixation of the gastric tube to the prepancreatic fascia and stapler line’s over-sewn running suture during LSG, introduced lately, are beneficial in preventing the postoperative functional stenosis of the LSG, contributing to the improvement of the patient’s quality of life.


KEY WORDS: Gastrectomy; Constriction, pathologic; Surgery

inizio pagina