Laparoscopic Sleeve Gastrectomy with Endoscopic Versus Bougie Calibration: Results of a Prospective Study

Ruíz-Tóvar, Jaime; Sola-VeraJavier,; MirandaElena,; Muñoz, José Luis; Perez-RabascoEstefania,; Arroyo, Antonio; CalpenaRafael,

doi:10.1089/lap.2014.0104

Cited by 11 publications

(9 citation statements)

References 14 publications

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“…These results suggest that EGD use may be protective against dehydration-related complications after LSG. This is consistent with existing literature, which has found lower rates of complications when an EGD is used intraoperatively 17,18. One possible explanation is the ability to directly visualize the resulting sleeve to assess for angulation, twisting, and narrowing at the incisura, which is an advantage over bougie use alone.…”

Section: Discussionsupporting

confidence: 89%

“…However, our results demonstrated that EGD alone, as well as a bougie coupled with EGD, had significantly lower rates of dehydration compared with bougie alone, while EGD alone compared with bougie coupled with EGD demonstrated equivalent outcomes (Table 4). Complications directly related to EGD use during LSG were not reported within our review of the literature 14–18. Adverse outcomes following EGD have been reported, including throat and abdominal discomfort, perforation, bleeding, and infection 23.…”

Section: Discussionmentioning

confidence: 89%

“…This is consistent with existing literature, which has found lower rates of complications when an EGD is used intraoperatively. 17,18 One possible explanation is the ability to directly visualize the resulting sleeve to assess for angulation, twisting, and narrowing at the incisura, which is an advantage over bougie use alone. The technique of using an EGD to assist with the visualization of gastric resection has been previously described in the literature.…”

Section: Discussionmentioning

confidence: 99%

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The Effect of Sizing Device Use During Laparoscopic Sleeve Gastrectomy on Rates of Postoperative Dehydration and Other 30-day Complications

DeAngelis

Lee

Habboosh

et al. 2023

Surgical Laparoscopy, Endoscopy &Amp; Percutaneous Techniques

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Background: During laparoscopic sleeve gastrectomy (LSG), many surgeons use an intraoperative sizing device. However, the choice of intraoperative sizing device varies and the optimal choice or combination of sizing devices, such as a bougie or esophagogastroduodenoscopy (EGD), is not known. The purpose of this study was to determine if there is an association between the use of a sizing device or a combination of sizing devices on rates of dehydration, bleeding, and staple line leak following LSG. Materials and Methods: Patients between the ages of 18 to 80 who underwent elective LSG were identified using the American College of Surgeons Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (ACS-MBSAQIP) database from 2015 to 2019. Postoperative outcomes, including rates of dehydration, bleeding, and staple line leak, were compared across 4 groups: those that utilized bougie and EGD (both), those that utilized only bougie (bougie only), those that utilized only EGD (EGD only), and those that did not utilize either sizing device (neither). Results: In all, 533,151 cases met the inclusion criteria. On univariate analysis, the bougie-only group experienced the highest rates of dehydration events. On multivariate analysis, the use of both sizing devices was associated with significantly lower odds of events related to dehydration versus bougie only (aOR 0.869, P=0.0002), and bougie only was associated with significantly higher odds of events related to dehydration versus EGD only (aOR 1.773, P=0.0006). The neither-sizing device group did not show any statistically significant differences in any of the comparisons. Conclusions: Bougie use alone was associated with more dehydration-related complications, while EGD use demonstrated a protective effect. Not using a sizing device was associated with equivalent outcomes to all combinations of sizing devices. These findings highlight the need for the standardization of sizing devices during LSG and suggest that foregoing sizing devices may be a management option without early adverse sequelae.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

The Effect of Sizing Device Use During Laparoscopic Sleeve Gastrectomy on Rates of Postoperative Dehydration and Other 30-day Complications

DeAngelis

Lee

Habboosh

et al. 2023

Surgical Laparoscopy, Endoscopy &Amp; Percutaneous Techniques

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“…According to published articles on IOLT for gastric cancer surgery, bariatric surgery, colorectal surgery and our own experience, we found that IOLT can be performed by gastroscopy or gastric tubes. Interestingly, researchers found that IOLT performed with gastroscopy had statistically signi cant lower PAL rates than IOLT performed with gastric tubes had (30,31). When compared with IOLT using gastric tubes, intraoperative gastroscopy had the advantage of detecting and preventing severe complications such as esophageal perforation.…”

Section: Discussionmentioning

confidence: 99%

A Comparison of the Postoperative Outcomes Between Intraoperative Leak Testing and Non-Intraoperative Leak Testing for Gastric Cancer Surgery: A Systematic Review and Meta-analysis

Tian

Liu

Bai

et al. 2022

Preprint

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Purpose Postoperative anastomotic leakage (PAL) is a serious complication of gastric cancer surgery. Although perioperative management has made significant progress, anastomotic leakage (AL) cannot always be prevented. Intraoperative leak testing (IOLT) may reduce the incidence of PAL and other postoperative complications. The aim of this study is to assess the relationship between IOLT and postoperative surgical complications in gastric cancer surgery. Materials and methods In this meta-analysis, we searched the PubMed, Embase, and Cochrane Library databases for clinical trials to assess the application of IOLT in gastric cancer surgery. Studies comparing the postoperative outcomes of IOLT and non-intraoperative leak testing (NIOLT) were included. Quality assessment, heterogeneity, risk of bias, and the level-of-evidence of the inclusions were evaluated. PAL, anastomosis-related complications, 30-day mortality, and reoperation rates were compared between the IOLT and NIOLT group. Results Our literature search returned 975 results, from which 3 trials (929 total patients) were included in our meta-analysis. Statistical heterogeneity was low. The primary outcome was PAL. IOLT statistically reduced the risk of PAL [3.08% vs9.54%; risk ratios (RR) 0.336, 95% CI, 0.189–0.600, P = 0.000]. It was also found that IOLT can lower the incidence of other postoperative outcomes. Anastomosis-related complication rates [3.94% vs13.14%; risk ratios (RR) 0.323, 95% CI, 0.182–0.572, P = 0.000] were significantly higher in the NIOLT group than the IOLT group. Moreover, IOLT was associated with lower reoperation rates [2.36% vs9.14%; risk ratios (RR) 0.301, 95% CI, 0.145–0.621, P = 0.001]. Conclusion Due to the lower incidence of PAL, anastomosis-related complications, and reoperation rates, IOLT is recommended in gastric cancer surgery.

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“…Finally, we recommend as described by Athanasiou et al that a member of the surgical team performs the intraoperative endoscopy. We feel more bariatric surgeons need to be familiar with endoscopy as this is an important adjunct to the armamentarium of a bariatric surgeon [2][3][4].…”

mentioning

confidence: 99%

The Use of Intraoperative Endoscopy Decreases Postoperative Stenosis in Laparoscopic Sleeve Gastrectomy

et al. 2016

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Laparoscopic Sleeve Gastrectomy with Endoscopic Versus Bougie Calibration: Results of a Prospective Study

Abstract: Endoscopic calibration is associated with lower postoperative complications after laparoscopic sleeve gastrectomy.

Cited by 11 publications

References 14 publications

The Effect of Sizing Device Use During Laparoscopic Sleeve Gastrectomy on Rates of Postoperative Dehydration and Other 30-day Complications

The Effect of Sizing Device Use During Laparoscopic Sleeve Gastrectomy on Rates of Postoperative Dehydration and Other 30-day Complications

A Comparison of the Postoperative Outcomes Between Intraoperative Leak Testing and Non-Intraoperative Leak Testing for Gastric Cancer Surgery: A Systematic Review and Meta-analysis

The Use of Intraoperative Endoscopy Decreases Postoperative Stenosis in Laparoscopic Sleeve Gastrectomy

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