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The use of bovine pericardial strips on linear stapler to reduce extraluminal bleeding during laparoscopic gastric bypass: prospective randomized clinical trial.
Obes Surg. 2004 Oct; 14(9):1198-202.OS

Abstract

BACKGROUND

A prospective comparison was conducted of extraluminal bleeding following gastric transection with or without staple-line reinforcement by dehydrated bovine pericardium (Peri-Strips Dry--PSD) during laparoscopic Roux-en-Y gastric bypass (LRYGBP).

METHODS

From January 2001 to September 2003, 98 consecutive morbidly obese patients underwent LRYGBP. Patients were randomly allocated to 2 groups according to the use (Group A, n= 50) or not (Group B, n= 48) of Peri-Strips Dry. In both groups, mortality, intra- and postoperative early and late complications, operating-time, number of hemostatic clips used, blood transfusion and any specific event directly related to the prosthetic material were prospectively evaluated. Data were expressed as mean +/- SD except as otherwise indicated. Statistical analysis was done by means of Student t-test and Fisher exact test. P-value cut off for statistical significance was set at 0.05.

RESULTS

Intra- and postoperative mortality were absent. Intra-operative methylene blue test was positive in 6/48 (12.5%) of Group B patients (P<0.001). Overall laparotomic conversion was 3/98 patients (3.1%). One/48 Group B patient was converted because of unsatisfactory exposure and one for linear stapler misfire. One/50 Group A patients was converted for short gastric vessels bleeding during dissection. No patients were re-operated or transfused because of extraluminal bleeding. Mean number of clips used was significantly lower in Group A patients (5 vs 23, P<0.001). The operating-time was significantly less in Group A patients (120+/-60 vs 220+/-100 minutes, P<0.01).

CONCLUSIONS

Gastric staple-lines reinforced with Peri-Strips Dry result in a significant reduction in the number of Endo-clips used and prevent bleeding. A dry operating field was obtained, and operating-time was significantly reduced. No adverse events could be related to the use PSD.

Authors+Show Affiliations

ASL NA1-Laparoscopic and Minimally Invasive Surgical Unit, S. Giovanni Bosco Hospital and Federico II University, Piazza Vittoria 7, 80121 Naples, Italy. luigiangrisani@chururgiaobesita.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

15527634

Citation

Angrisani, Luigi, et al. "The Use of Bovine Pericardial Strips On Linear Stapler to Reduce Extraluminal Bleeding During Laparoscopic Gastric Bypass: Prospective Randomized Clinical Trial." Obesity Surgery, vol. 14, no. 9, 2004, pp. 1198-202.
Angrisani L, Lorenzo M, Borrelli V, et al. The use of bovine pericardial strips on linear stapler to reduce extraluminal bleeding during laparoscopic gastric bypass: prospective randomized clinical trial. Obes Surg. 2004;14(9):1198-202.
Angrisani, L., Lorenzo, M., Borrelli, V., Ciannella, M., Bassi, U. A., & Scarano, P. (2004). The use of bovine pericardial strips on linear stapler to reduce extraluminal bleeding during laparoscopic gastric bypass: prospective randomized clinical trial. Obesity Surgery, 14(9), 1198-202.
Angrisani L, et al. The Use of Bovine Pericardial Strips On Linear Stapler to Reduce Extraluminal Bleeding During Laparoscopic Gastric Bypass: Prospective Randomized Clinical Trial. Obes Surg. 2004;14(9):1198-202. PubMed PMID: 15527634.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The use of bovine pericardial strips on linear stapler to reduce extraluminal bleeding during laparoscopic gastric bypass: prospective randomized clinical trial. AU - Angrisani,Luigi, AU - Lorenzo,Michele, AU - Borrelli,Vincenzo, AU - Ciannella,Monica, AU - Bassi,Uberto Andrea, AU - Scarano,Paolo, PY - 2004/11/6/pubmed PY - 2005/2/19/medline PY - 2004/11/6/entrez SP - 1198 EP - 202 JF - Obesity surgery JO - Obes Surg VL - 14 IS - 9 N2 - BACKGROUND: A prospective comparison was conducted of extraluminal bleeding following gastric transection with or without staple-line reinforcement by dehydrated bovine pericardium (Peri-Strips Dry--PSD) during laparoscopic Roux-en-Y gastric bypass (LRYGBP). METHODS: From January 2001 to September 2003, 98 consecutive morbidly obese patients underwent LRYGBP. Patients were randomly allocated to 2 groups according to the use (Group A, n= 50) or not (Group B, n= 48) of Peri-Strips Dry. In both groups, mortality, intra- and postoperative early and late complications, operating-time, number of hemostatic clips used, blood transfusion and any specific event directly related to the prosthetic material were prospectively evaluated. Data were expressed as mean +/- SD except as otherwise indicated. Statistical analysis was done by means of Student t-test and Fisher exact test. P-value cut off for statistical significance was set at 0.05. RESULTS: Intra- and postoperative mortality were absent. Intra-operative methylene blue test was positive in 6/48 (12.5%) of Group B patients (P<0.001). Overall laparotomic conversion was 3/98 patients (3.1%). One/48 Group B patient was converted because of unsatisfactory exposure and one for linear stapler misfire. One/50 Group A patients was converted for short gastric vessels bleeding during dissection. No patients were re-operated or transfused because of extraluminal bleeding. Mean number of clips used was significantly lower in Group A patients (5 vs 23, P<0.001). The operating-time was significantly less in Group A patients (120+/-60 vs 220+/-100 minutes, P<0.01). CONCLUSIONS: Gastric staple-lines reinforced with Peri-Strips Dry result in a significant reduction in the number of Endo-clips used and prevent bleeding. A dry operating field was obtained, and operating-time was significantly reduced. No adverse events could be related to the use PSD. SN - 0960-8923 UR - https://www.unboundmedicine.com/medline/citation/15527634/The_use_of_bovine_pericardial_strips_on_linear_stapler_to_reduce_extraluminal_bleeding_during_laparoscopic_gastric_bypass:_prospective_randomized_clinical_trial_ L2 - https://dx.doi.org/10.1381/0960892042387075 DB - PRIME DP - Unbound Medicine ER -