Evidence map›Paper›PMID 35226162›Full record

ArticleSurgical endoscopy2022

Is staple line oversewing in patients on chronic anticoagulation during laparoscopic sleeve gastrectomy necessary? Propensity score matching analysis using the 2015-2018 MBSAQIP.

Raul Sebastian, Omar M Ghanem, Jorge Cornejo, Thomas Ruttger, J Paul Perales-Villarroel, Gina Adrales, Christina Li

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Article in Surgical endoscopy, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
0.9field-weighted citation impact, top 28% 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

5 citing papers in PubMed, 6 citations in OpenAlex.

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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

7 authors at 4 institutions in 1 country.

Raul SebastianDepartment of Surgery, Northwest Hospital, 5401 Old Court Road, Randallstown, MD, 21133, USA. rsebast04@gmail.com.
Omar M GhanemDepartment of Surgery, Mayo Clinic, Rochester, MN, USA.
Jorge CornejoDepartment of Surgery, Northwest Hospital, 5401 Old Court Road, Randallstown, MD, 21133, USA.
Thomas RuttgerDepartment of Surgery, Northwest Hospital, 5401 Old Court Road, Randallstown, MD, 21133, USA.
J Paul Perales-VillarroelMiami Cancer Research Center, Miami, FL, USA.
Gina AdralesDepartment of Surgery, The Johns Hopkins University, Baltimore, MD, USA.
Christina LiDepartment of Surgery, Northwest Hospital, 5401 Old Court Road, Randallstown, MD, 21133, USA.
Northwest Hospital · USCancer Research Center · USJohns Hopkins University · USMayo Clinic in Arizona · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThere is an increased incidence of post-operative bleeding in patients on chronic anticoagulation (CAC). This incited some surgeons to oversew the sleeve staple line as a potentially preventive measure for post-operative bleeding. However, there is no clear evidence to assess the effectiveness of staple line oversewing during laparoscopic sleeve gastrectomy (LSG) in patients with CAC.

methodsUsing the 2015-2018 metabolic and bariatric surgery accreditation and quality improvement program database, patients between ages 18 and 65 who underwent LSG were included. To investigate the role of CAC, we performed 1:1 propensity score matching (PSM) between the CAC and non-CAC patients. Then, to explore the impact of oversewing, we focused on the CAC patients and divided them into 2 subgroups: oversewing versus non-oversewing. PSM was also performed to compare both subgroups. To avoid confounders, both PSM analyses were performed using 22 preoperative characteristics. 30-day postoperative outcomes including bleeding and blood transfusion requirement were assessed.

results402,826 patients underwent LSG. 9148 patients (2.3%) were on CAC. In the CAC cohort (8843 matched cases), the anticoagulated patients showed significant increase in postoperative bleeding (1.2% vs. 0.5%; P < 0.001), blood transfusion requirements (1.7% vs. 0.7%; P < 0.001), unplanned ICU admissions (2.0% vs. 1.3%; P = 0.001), interventions (2.0% vs. 1.5%; P = 0.015), and readmissions (6.2% vs. 4.7%; P < 0.001). 1939 (21.2%) patients on CAC underwent oversewing during the LSG. The operative time was significantly longer in these patients (87.11 ± 40 vs. 76.19 ± 37; P < 0.001). Patients who underwent oversewing showed similar results in 30-day outcomes as those who did not, with no statistical difference, including postoperative bleeding (1.0% vs. 0.9%; P = 0.8) and blood transfusion requirements (1.4% vs. 1.8%; P = 0.9).

conclusionIncidences of post-operative bleeding and blood transfusion requirements are higher in patients on CAC during the LSG. Oversewing the sleeve staple line leads to longer operative times without additional benefit in 30-day outcomes.

Indexed as

LaparoscopyObesity, MorbidAdolescentAdultAgedAnticoagulantsGastrectomyHumansMiddle AgedPostoperative ComplicationsPostoperative HemorrhagePropensity ScoreRetrospective StudiesSurgical StaplingTreatment OutcomeYoung AdultAnticoagulantsBariatric surgeryChronic anticoagulationLaparoscopic sleeve gastrectomyMinimally invasive surgeryStaple line oversewing

Identifiers

PMID35226162
OpenAlexW4214642929

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.