ArticleObesity surgery2014
Does tissue ischemia actually contribute to leak after sleeve gastrectomy? An experimental study.
Article in Obesity surgery, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
What it found
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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.
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Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Pooled it
- Oversewing/Suturing of the Staple Line During Sleeve Gastrectomy Is an Effective and Affordable Staple Line Reinforcement Method: a Meta-analysis of Randomized Controlled Trials.Obesity surgery · 2023Review
- Mechanism of Staple Line Leak After Sleeve Gastrectomy via Isobaric Pressurisation Concentrating Stress Forces at the Proximal Staple Line.Obesity surgery · 2022Article
- An Experimental Study of Intraluminal Hyperpressure Reproducing a Gastric Leak Following a Sleeve Gastrectomy.Obesity surgery · 2019Article
- [Endoscopic management of complications after laparoscopic sleeve gastrectomy].Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen · 2018Review
- The Effects of Bougie Diameters on Tissue Oxygen Levels After Sleeve Gastrectomy: A Randomized Experimental TrialBalkan medical journal · 2018Article
- The visualization of gastro-esophageal junction vascular supply during a laparoscopic sleeve gastrectomy. Role of a new device.Updates in surgery · 2017Article
- Staple line oversewing during laparoscopic sleeve gastrectomy.Annals of the Royal College of Surgeons of England · 2017Review
- Intraoperative Patterns of Gastric Microperfusion During Laparoscopic Sleeve Gastrectomy.Obesity surgery · 2017Article
- Postoperative Bleeding and Leakage after Sleeve Gastrectomy: a Single-Center Experience.Obesity surgery · 2016Article
- Leaks after laparoscopic sleeve gastrectomy: overview of pathogenesis and risk factors.Langenbeck's archives of surgery · 2016Review
- [Anastomosis and suture insufficiency after interventions for bariatric and metabolic surgery].Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen · 2015Review
- Laparoscopic Sleeve Gastrectomy for Morbid Obesity with Intra-operative Endoscopy: Lessons We Learned After 100 Consecutive Patients.Obesity surgery · 2015Article
- Complications of staple line and anastomoses following laparoscopic bariatric surgery.Annals of gastroenterologyReview
- Staple Line Reinforcement Methods in Laparoscopic Sleeve Gastrectomy: Comparison of Burst Pressures and Leaks.JSLS : Journal of the Society of Laparoendoscopic SurgeonsArticle
Corrections and comments
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundStaple line leak, although rare, is among the most common postoperative complications after sleeve gastrectomy (SG) and usually occurs in the gastroesophageal (GE) junction. Increased intragastric pressure, regional ischemia, and technical failure of stapling devices have been reported as the main risk factors of postoperative leak. The aim of this study was to evaluate the impact of ischemia and intraluminal pressure in leak appearance.
methodsLandrace swine (n = 12) were subjected to SG and total gastrectomy subsequently. Lactic acid, glycerol, and pyruvate were measured by microdialysis in GE junction and pylorus before and nine times after operation, and lactate/pyruvate (L/P) ratio was calculated as well. Moreover, ex vivo air was insufflated inside the tubularized stomach till a rupture of the staple line occurs. Maximum air pressure reached and location of rupture were recorded.
resultsIncrease of lactic acid and L/P ratio were demonstrated in GE junction measurements; however, when the measurements between GE junction and pylorus were compared, no statistically significant differences were found, with the exception of a slightly increased lactate concentration in pylorus in the midst of measurements. The maximum air pressure recorded varied from 3 to 75 mmHg (mean 24.5 mmHg) and the majority of ruptures (n = 8) occurred in GE junction. In one of them, clip displacement was noticed.
conclusionsNo evidence of increased ischemia in GE junction compared to pylorus was recorded. Increased intraluminal pressure and stapling malfunction may play the most important role in leak appearance.
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Registered trials
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.