Evidence map›Paper›PMID 39218833›Full record

ArticleSurgical endoscopy2024

Six-year analysis of 30-day post-operative leaks for primary sleeve gastrectomy: a MBSAQIP database study.

Narayan Osti, Ameer Aboud, Shamon Gumbs, Raja Sabbagh, Stephen Carryl, Sharique Nazir, Javier Andrade, Karina McArthur

Abstract read
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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 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

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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.

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. Article
4 · The record

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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.

Narayan OstiDepartment of Surgery Harlem Hospital Center, NYC Health+Hospitals/Harlem, 506 Lenox Ave, MLK 12.107, New York, NY, 10037, USA. ostin@nychhc.org.ORCID 0000-0002-8096-5472
Ameer AboudDepartment of Surgery Harlem Hospital Center, NYC Health+Hospitals/Harlem, 506 Lenox Ave, MLK 12.107, New York, NY, 10037, USA.
Shamon GumbsDepartment of Surgery Harlem Hospital Center, NYC Health+Hospitals/Harlem, 506 Lenox Ave, MLK 12.107, New York, NY, 10037, USA.
Raja SabbaghDepartment of Surgery Woodhull Medical Center, New York, USA.
Stephen CarrylDepartment of Surgery Harlem Hospital Center, NYC Health+Hospitals/Harlem, 506 Lenox Ave, MLK 12.107, New York, NY, 10037, USA.
Sharique NazirDepartment of Surgery Harlem Hospital Center, NYC Health+Hospitals/Harlem, 506 Lenox Ave, MLK 12.107, New York, NY, 10037, USA.
Javier AndradeDepartment of Surgery Woodhull Medical Center, New York, USA.
Karina McArthurDepartment of Surgery Harlem Hospital Center, NYC Health+Hospitals/Harlem, 506 Lenox Ave, MLK 12.107, New York, NY, 10037, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSleeve gastrectomy is the most performed bariatric surgery. Post-operative gastric sleeve leaks, although rare, are dreaded complications. This study aims to perform an updated investigation of the factors associated with sleeve leaks.

methodsThis retrospective cohort study analyzed 692,554 cases from the MBSAQIP database (2016-2021) with CPT code 43,775 for primary sleeve gastrectomy. We excluded emergency operations, conversions/revisions, endoscopic interventions, patient with prior foregut surgery, and open operations. Multivariate logistic regression analysis (STATA version 15) was performed to identify factors associated with sleeve gastrectomy leaks.

resultsOut of 692,554 patients, 600,910 (86.77%) patients underwent laparoscopic sleeve gastrectomy, and 91,644 (13.23%) patients underwent robotic sleeve gastrectomy. 1179 (0.17%) developed leaks within 30 days; 177(0.19%) were in the robotic group and 1002 (0.17%) in the laparoscopic group with no significant difference in leak rates between two groups on multivariate analysis. Black patients had lower odds of having leaks as compared to white patients (Odds Ratio (OR): 0.68 (0.56-0.82); p < 0.01). Hispanic patients had lower odds of having leak as compared to non-Hispanics. Factors associated with higher leak odds (p < 0.05) included hypertension, GERD, smoking, immunosuppression, increased operating time, and albumin < 3.5 g/dl. Higher odds of leaks were observed in years 2016-2019 vs 2020-2021 (OR: 1.44 (1.25-1.65), p < 0.01). Higher odds of leak in operations with general surgeons compared to bariatric surgeons was found (OR: 1.46 (1.04-2.02), p = 0.02); observed only on robotic group on subgroup analysis (OR: 2.2 (1.2-4.2), p = 0.02). Staple line reinforcement, oversewing, and performance of leak test showed no differences in leak rate. Bougie size and distance from pylorus were not associated with changes in leak rate.

conclusionThis study provides updated insights into the factors associated with sleeve leaks, reinforcing information gained from prior studies. A higher association of leak among general surgeons could represent a learning curve for new robotic general surgeons. The overall decreasing trend for gastric sleeve leak is encouraging and may be a sign of improved techniques.

Indexed as

Anastomotic LeakGastrectomyLaparoscopyObesity, MorbidRobotic Surgical ProceduresAdultBariatric SurgeryDatabases, FactualFemaleHumansMaleMiddle AgedRetrospective StudiesRisk FactorsBariatric surgeryLeakMBSAQIPPrimary sleeveRobotic vs laparoscopicSleeve gastrectomyStaple line reinforcement

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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.