Evidence map›Paper›PMID 18795383›Full record

SynthesisObesity surgery2009

Reinforcement does not necessarily reduce the rate of staple line leaks after sleeve gastrectomy. A review of the literature and clinical experiences.

Bo Chen, Andreas Kiriakopoulos, Dimitrios Tsakayannis, Mitchell S Wachtel, Dimitrios Linos, Eldo E Frezza

Abstract readComparative StudyMeta-AnalysisMulticenter Study
PubMed Publisher
In one paragraph

Synthesis in Obesity surgery, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 78 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
78citing papers in PubMed, 5 pooled it
10.1field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

78 citing papers in PubMed, 5 syntheses or guidelines pooled it, 217 citations in OpenAlex.

  1. Pooled it
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  5. A systematic review of staple-line reinforcement in laparoscopic sleeve gastrectomy.JSLS : Journal of the Society of Laparoendoscopic Surgeons
    Pooled it
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  16. Is phenytoin a safe agent for staple line recovery after gastric sleeve surgery in rats?Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES · 2023
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  18. Review
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  20. Article

18 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 4 institutions in 3 countries.

Bo ChenDepartment of General Surgery, Qilu Hospital of Shandong University, Jinan, 250012, China.
Andreas KiriakopoulosFirst Surgical Clinic, Department of Surgery, ''Hygeia'' Hospital, Athens, Greece.
Dimitrios TsakayannisFirst Surgical Clinic, Department of Surgery, ''Hygeia'' Hospital, Athens, Greece.
Mitchell S WachtelDepartment of Pathology, Texas Tech University Health Sciences Center, Lubbock, TX, USA.
Dimitrios LinosFirst Surgical Clinic, Department of Surgery, ''Hygeia'' Hospital, Athens, Greece.
Eldo E FrezzaDepartment of Surgery, University of Alabama, VAMC Surgical Service 112, 700 19th Street South, Birmingham, AL, 35233, USA. eldo.frezza@ccc.uab.edu.
Hygeia Hospital · GRQilu Hospital of Shandong University · CNTexas Tech University · USUniversity of Alabama · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundLaparoscopic sleeve gastrectomy (SG) is an accepted bariatric procedure, with an advantaged by a low complication rate. A feared complication is stapler line leak. Buttressing materials have been suggested as a means of reducing staple line leak rates. We analyzed the leak rates from published series to help in demonstrating a potential cause.

methodsThe study was institutional review board (IRB) approved retrospectively. A Medline search using the key words sleeve gastrectomy and bariatric surgery obtained 54 articles. Attention was restricted to 11 articles written in English that listed numbers of gastrectomy procedures and leaks. Poisson regression assessed the possibility that patients who received buttressing materials had a reduced rate of leaks.

resultsThirty-five patients were evaluated from Greece (15) and the United States (20); two patients developed staple line leaks that appeared to be related to problems associated with buttressing materials. Eleven prior studies and the present series yielded 1,589 procedures, 15 (0.94%) of which were complicated by leaks. The leak rate for patients who were known to have received reinforcement of some sort was 1.45 (95% confidence interval 0.41-3.43) times that for other patients. To detect a difference between 1% and 0.5% as statistically significant in 80% of cases, with a two tailed test and alpha set at 0.05, would require 9,346 procedures.

conclusionsThere is no reason to believe, at this point, that reduction in leak rates occur because reinforcement is used. Because the leak rate is small, the routine reinforcement of the staple line after sleeve gastrectomy is questionable at best, although a decrease in hemorrhage has been reported.

Indexed as

AdolescentAdultCohort StudiesFemaleGastrectomyHumansLaparoscopyMaleMiddle AgedReoperationRetrospective StudiesRisk FactorsSurgical StaplingSurgical Wound DehiscenceTreatment OutcomeYoung Adult

Identifiers

PMID18795383
OpenAlexW2028015032

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.