Evidence map›Paper›PMID 36701010›Full record

ArticleObesity surgery2023

Gastrojejunostomy Closure Technique and Risk of Leak: an Evaluation in Ex Vivo Porcine Models.

Bibek Das, Frances Ledesma, Hutan Ashrafian, Marcus Reddy, Omar A Khan, Matyas Fehervari

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Obesity surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
0.6field-weighted citation impact, top 33% 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

1 citing paper in PubMed, 1 synthesis or guideline pooled it, 2 citations in OpenAlex.

  1. Pooled it
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 3 institutions in 1 country.

Bibek DasDepartment of Surgery and Cancer, Faculty of Medicine, Imperial College London, Commonwealth Building, Hammersmith Hospital Campus, Du Cane Road, London, W12 0NN, UK. bibek.das07@imperial.ac.uk.ORCID 0000-0001-5982-0618
Frances LedesmaDepartment of Surgery, Imperial College Healthcare NHS Foundation Trust, London, UK.
Hutan AshrafianDepartment of Surgery and Cancer, Faculty of Medicine, Imperial College London, Commonwealth Building, Hammersmith Hospital Campus, Du Cane Road, London, W12 0NN, UK.
Marcus ReddyDepartment of Upper GI and Bariatric Surgery, St George's Hospital NHS Foundation Trust, London, UK.
Omar A KhanDepartment of Upper GI and Bariatric Surgery, St George's Hospital NHS Foundation Trust, London, UK.
Matyas FehervariDepartment of Surgery and Cancer, Faculty of Medicine, Imperial College London, Commonwealth Building, Hammersmith Hospital Campus, Du Cane Road, London, W12 0NN, UK.
St George’s University Hospitals NHS Foundation Trust · GBHammersmith Hospital · GBImperial College Healthcare NHS Trust · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionRoux-en-Y gastric bypass (RYGB) is one of the most commonly performed bariatric operations worldwide. Leaks following RYGB are rare, but the consequences can be devastating. Although most leaks occur at the gastrojejunostomy (GJ) anastomosis, there is a lack of data on modifiable technical factors that can reduce the risk of leaks. Therefore, we evaluated whether the leak pressure of a GJ linear stapled anastomosis is dependent on the closure technique.

methodsTwo expert surgeons constructed gastric pouches and GJ anastomoses on ex vivo porcine models in a laparoscopic simulator using 30-mm and 45-mm endoscopic staplers. The GJ anastomosis was closed using either a single layer suture, double layer suture or stapler. The endpoints were leak pressure to air insufflation, measured by two independent observers, site of leak and internal circumference of the GJ anastomosis.

resultsIn total, 30 GJ anastomoses were constructed (30 mm, n = 15; 45 mm, n = 15). The GJ anastomosis was closed using single layer (n = 9), double layer (n = 9) and stapled techniques (n = 12). Inter-observer agreement was high. Stapled and double layer closures were more resilient than a single layer closure, with 75% (9/12) stapled closures remaining intact at < 70 mmHg. GJ stoma circumference was lower using a 30-mm stapler (64.8 mm vs 80.2 mm; p < 0.05) but independent of closure technique. The most common leak site was the corner of the closure (67%).

conclusionIn summary, the GJ anastomosis closure technique may be a modifiable factor to prevent anastomotic leak.

Indexed as

Gastric BypassLaparoscopyObesity, MorbidAnastomosis, Roux-en-YAnastomotic LeakAnimalsStomachSwineAnastomotic leakBariatric surgeryGastric bypassGastrojejunostomyMetabolic surgery

Identifiers

PMID36701010
PMCPMC9988758
OpenAlexW4318164947

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.