Evidence map›Paper›PMID 39037465›Full record

ArticleSurgical endoscopy2024

Increased staple line leak rates following re-sleeve: analysis comparing re-sleeve versus Roux-en-Y gastric bypass conversion and primary sleeve gastrectomy.

Jorge Cornejo, Alba Zevallos, Joaquin Sarmiento, Fatemeh Shojaeian, Farzad Mokhtari-Esbuie, Gina Adrales, Christina Li, Raul Sebastian

Abstract readComparative Study
PubMed Publisher
In one paragraph

Article in Surgical endoscopy, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
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

4 citing papers in PubMed.

  1. Article
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  4. Review
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

8 authors.

Jorge CornejoDepartment of Surgery, Northwest Hospital, 5401 Old Court Road, Randallstown, MD, 21133, USA.
Alba ZevallosDepartment of Surgery, Northwest Hospital, 5401 Old Court Road, Randallstown, MD, 21133, USA.
Joaquin SarmientoDepartment of Surgery, Northwest Hospital, 5401 Old Court Road, Randallstown, MD, 21133, USA.
Fatemeh ShojaeianDepartment of Surgery, The Johns Hopkins University, Baltimore, MD, USA.
Farzad Mokhtari-EsbuieDepartment of Surgery, The Johns Hopkins University, Baltimore, MD, 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.
Raul SebastianDepartment of Surgery, Northwest Hospital, 5401 Old Court Road, Randallstown, MD, 21133, USA. Rsebast04@gmail.com.ORCID 0000-0001-5567-9733

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSleeve gastrectomy is the most common bariatric procedure and its long-term complications include inadequate weight loss, weight regain, and de novo GERD, often requiring revisional surgery. Revisions, notably re-sleeve and conversion to Roux-en-Y gastric bypass (RYGB), are frequently performed, but safety data is limited. Herein, we used the MBSAQIP database to compare 30 day outcomes of primary sleeve gastrectomy (SG) with re-sleeve (RS) and SG to RYGB conversion.

methodsPatients who underwent primary SG, RS, and SG to RYGB conversion within the MBSAQIP data registry from January 1, 2020 to December 31, 2022 were included in this study. Using Propensity Score Matching analysis, the cohorts were matched for 23 preoperative characteristics. We then compared 30 day postoperative outcomes and bariatric-specific complications between primary SG and RS (analysis 1) and between RS and SG to RYGB conversion (analysis 2).

resultsA total of 302,961 were included. The matched cohorts in analysis 1 (n = 1630) and analysis 2 (n = 1633) had similar pre-operative characteristics. Propensity-matched outcomes in analysis 1 showed that patients in the RS group had significantly higher staple line leak (1.3% vs. 0.1%, p < 0.001) when compared to primary SG. Similarly, longer operative times (90.16 ± 51.90 min vs. 68.32 ± 37.54 min, p < 0.001) and higher rates of readmissions (5.5% vs. 2.1%, p < 0.001), reoperations (2.3% vs. 0.6%, p < 0.001), interventions (2.5% vs. 0.4%, p < 0.001) were found in those who underwent RS. In analysis 2, RS showed higher leak rates (1.3% vs. 0.5%, p = 0.015) when compared to conversion from SG to RYGB.

conclusionThe RS group has a higher risk of staple line leaks compared to primary SG and conversion from SG to RYGB. In our study, there was a 2.6-fold increase in staple line leak after re-sleeve compared to RYGB conversion and a 13-fold increase compared to primary SG.

Indexed as

Anastomotic LeakGastrectomyGastric BypassObesity, MorbidReoperationAdultFemaleHumansMaleMiddle AgedPostoperative ComplicationsPropensity ScoreRetrospective StudiesSurgical StaplingBariatric surgeryConversionLaparoscopic gastric bypassMinimally invasive surgeryRe-sleeveSleeve gastrectomy

Identifiers

PMID39037465

What OpenQuestion holds

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Registered trials

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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.