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Glycolide copolymer staple-line reinforcement reduces staple site bleeding during laparoscopic gastric bypass: a prospective randomized trial.
Arch Surg. 2005 Aug; 140(8):773-8.AS

Abstract

HYPOTHESIS

The use of staple-line reinforcement sleeves during laparoscopic gastric bypass reduces staple-line bleeding, which may translate into a reduction in the rate of gastrointestinal hemorrhage.

DESIGN

Prospective randomized trial.

SETTING

University hospital.

PATIENTS AND INTERVENTIONS

Thirty-four patients undergoing laparoscopic gastric bypass were randomly assigned to receive either no reinforcement (control group, n = 17) or reinforcement of the staple line with glycolic copolymer sleeves (treatment group, n = 17).

MAIN OUTCOME MEASURES

Demographic data, the number of stapler loads used, the number of staple-line bleeding sites, the amount of blood loss, the length of time required to obtain hemostasis of the staple lines, operative time, intraoperative and postoperative complications, and serial hemoglobin levels.

RESULTS

The mean number of stapler loads used was similar between groups. The mean number of staple-line bleeding sites was significantly fewer in the treatment group for division of gastric tissue (0.4 vs 2.5 bleeding sites), jejunal tissue (0.1 vs 0.6 bleeding site), and mesenteric tissue (0 vs 0.8 bleeding site). The mean blood loss was lower in the treatment group (84 vs 129 mL). Staple misfire occurred in 1 (0.7%) of 143 stapler loads used in the treatment group compared with 0 (0%) of 138 stapler loads used in the control group. The time to obtain staple-line hemostasis was shorter in the treatment group (1.2 vs 10.1 minutes). The total operative time was similar between groups. There was no mortality or postoperative leaks. One patient in the control group had postoperative gastrointestinal hemorrhage requiring blood transfusion and reoperation. There was no significant difference in the mean hemoglobin level between groups on the first postoperative day.

CONCLUSIONS

The use of glycolide copolymer staple-line reinforcement sleeves in patients undergoing laparoscopic gastric bypass is safe and significantly reduces staple-line bleeding sites and may reduce the incidence of gastrointestinal hemorrhage.

Authors+Show Affiliations

Department of Surgery, Division of Gastrointestinal Surgery, University of California-Irvine Medical Center, 101 The City Drive, Orange, CA 92868, USA. ninhn@uci.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

16103288

Citation

Nguyen, Ninh T., et al. "Glycolide Copolymer Staple-line Reinforcement Reduces Staple Site Bleeding During Laparoscopic Gastric Bypass: a Prospective Randomized Trial." Archives of Surgery (Chicago, Ill. : 1960), vol. 140, no. 8, 2005, pp. 773-8.
Nguyen NT, Longoria M, Welbourne S, et al. Glycolide copolymer staple-line reinforcement reduces staple site bleeding during laparoscopic gastric bypass: a prospective randomized trial. Arch Surg. 2005;140(8):773-8.
Nguyen, N. T., Longoria, M., Welbourne, S., Sabio, A., & Wilson, S. E. (2005). Glycolide copolymer staple-line reinforcement reduces staple site bleeding during laparoscopic gastric bypass: a prospective randomized trial. Archives of Surgery (Chicago, Ill. : 1960), 140(8), 773-8.
Nguyen NT, et al. Glycolide Copolymer Staple-line Reinforcement Reduces Staple Site Bleeding During Laparoscopic Gastric Bypass: a Prospective Randomized Trial. Arch Surg. 2005;140(8):773-8. PubMed PMID: 16103288.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Glycolide copolymer staple-line reinforcement reduces staple site bleeding during laparoscopic gastric bypass: a prospective randomized trial. AU - Nguyen,Ninh T, AU - Longoria,Mario, AU - Welbourne,Susan, AU - Sabio,Allen, AU - Wilson,Samuel E, PY - 2005/8/17/pubmed PY - 2005/9/2/medline PY - 2005/8/17/entrez SP - 773 EP - 8 JF - Archives of surgery (Chicago, Ill. : 1960) JO - Arch Surg VL - 140 IS - 8 N2 - HYPOTHESIS: The use of staple-line reinforcement sleeves during laparoscopic gastric bypass reduces staple-line bleeding, which may translate into a reduction in the rate of gastrointestinal hemorrhage. DESIGN: Prospective randomized trial. SETTING: University hospital. PATIENTS AND INTERVENTIONS: Thirty-four patients undergoing laparoscopic gastric bypass were randomly assigned to receive either no reinforcement (control group, n = 17) or reinforcement of the staple line with glycolic copolymer sleeves (treatment group, n = 17). MAIN OUTCOME MEASURES: Demographic data, the number of stapler loads used, the number of staple-line bleeding sites, the amount of blood loss, the length of time required to obtain hemostasis of the staple lines, operative time, intraoperative and postoperative complications, and serial hemoglobin levels. RESULTS: The mean number of stapler loads used was similar between groups. The mean number of staple-line bleeding sites was significantly fewer in the treatment group for division of gastric tissue (0.4 vs 2.5 bleeding sites), jejunal tissue (0.1 vs 0.6 bleeding site), and mesenteric tissue (0 vs 0.8 bleeding site). The mean blood loss was lower in the treatment group (84 vs 129 mL). Staple misfire occurred in 1 (0.7%) of 143 stapler loads used in the treatment group compared with 0 (0%) of 138 stapler loads used in the control group. The time to obtain staple-line hemostasis was shorter in the treatment group (1.2 vs 10.1 minutes). The total operative time was similar between groups. There was no mortality or postoperative leaks. One patient in the control group had postoperative gastrointestinal hemorrhage requiring blood transfusion and reoperation. There was no significant difference in the mean hemoglobin level between groups on the first postoperative day. CONCLUSIONS: The use of glycolide copolymer staple-line reinforcement sleeves in patients undergoing laparoscopic gastric bypass is safe and significantly reduces staple-line bleeding sites and may reduce the incidence of gastrointestinal hemorrhage. SN - 0004-0010 UR - https://www.unboundmedicine.com/medline/citation/16103288/Glycolide_copolymer_staple_line_reinforcement_reduces_staple_site_bleeding_during_laparoscopic_gastric_bypass:_a_prospective_randomized_trial_ L2 - https://jamanetwork.com/journals/jamasurgery/fullarticle/10.1001/archsurg.140.8.773 DB - PRIME DP - Unbound Medicine ER -