Laparoscopic sleeve gastrectomy. Do we need to oversew the staple line?

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COD: 273-278 Categorie: ,

Mario Musella, Marco Milone, Marcello Bellini, Maddalena Leongito, Roberto Guarino, Francesco Milone

n. Ital. Chir., 2011 82: 273-277

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sleeve gastrectomy.
MATERIAL OF STUDY: A prospective randomized trial has been performed on 100 consecutive patients who underwent
laparoscopic sleeve gastrectomy. Just before the intervention patients were randomized to receive (Group A) or not receive
(Group B) a polypropylene 3-0 running oversewing suture of the staple line.
Results: By evaluating preoperative general demographics features and co-morbidities between group A and group B no
statistical difference was observed. Main complications evaluated were fistol, bleeding and stenosis and there were no significant
difference in fistulas occurrence (p = 0.55) and bleeding (p = 0,65) while on the other hand it has to be
remarked how sleeve stenosis has been significantly higher when oversew is performed (p=0.04).
DISCUSSION: Staple line leakage is a worrisome complication of laparoscopic sleeve gastrectomy (LSG). Despite some reports
describe oversewing of the staple line as the solution to prevent such problem; other authors have demonstrated the incidence
of leaks being the same in oversewed and not oversewed patients.
CONCLUSION: This randomized trial has so far shown oversew of LSG to be significantly useless to prevent fistulas formation
in patients selected according to our study design.

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