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Clinical results using bioabsorbable staple line reinforcement for circular staplers.
Am Surg. 2008 Jun; 74(6):462-7; discussion 467-8.AS

Abstract

Although linear surgical staple line reinforcement has been shown to increase anastomotic tensile strength in animal models and reduce the incidence of staple line bleeding and anastomotic leaks in colorectal surgery, the benefits of staple line reinforcement on circular stapled anastomoses in bariatric surgery remain unreported in the literature. The purpose if this study was to compare the incidence of anastomotic bleeding, leak, and stricture in patients undergoing laparoscopic gastric bypass with circular staple line reinforcements with those with no circular staple line reinforcements. Since May 2006, 138 consecutive patients (Group B) have undergone laparoscopic Roux-en-Y divided gastric bypass with a 25-mm circular stapled gastrojejunal anastomosis using GORE SEAMGUARD bioabsorbable circular staple line reinforcement (CBSG) with a mean follow up of 9 months. The incidence of anastomotic bleeding, leak, and stricture was compared with 255 similar patients (Group A) who underwent surgery before May 2006 without gastrojejunal reinforcement with a mean follow up of 22 months. The rates of anastomotic bleeding, leak, and stricture for Group B versus Group A were 0.7 per cent versus 1.1 per cent (P = 0.64); 0.7 per cent versus 1.9 per cent (P = 0.34); and 0.7 per cent versus 9.3 per cent (P = 0.0005), respectively. The use of CBSG reduced the incidence of anastomotic stricture by 93 per cent and the incidence of a composite end point of all anastomotic complications by 85 per cent. Our results indicate that the use of circular staple line reinforcement at the gastrojejunal anastomosis in patients undergoing laparoscopic gastric bypass significantly decreases the incidence of anastomotic stricture and a composite end point of all anastomotic complications. On this basis, strong consideration should be given to the routine use of CBSG staple line reinforcement in patients undergoing laparoscopic divided gastric bypass with a circular stapled gastrojejunal anastomosis.

Authors+Show Affiliations

Academic Department of Surgery, Greenville Hospital System University Medical Center, Greenville, South Carolina, USA. joneswesley@bellsouth.netNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

18556986

Citation

Jones, Wesley B., et al. "Clinical Results Using Bioabsorbable Staple Line Reinforcement for Circular Staplers." The American Surgeon, vol. 74, no. 6, 2008, pp. 462-7; discussion 467-8.
Jones WB, Myers KM, Traxler LB, et al. Clinical results using bioabsorbable staple line reinforcement for circular staplers. Am Surg. 2008;74(6):462-7; discussion 467-8.
Jones, W. B., Myers, K. M., Traxler, L. B., & Bour, E. S. (2008). Clinical results using bioabsorbable staple line reinforcement for circular staplers. The American Surgeon, 74(6), 462-7; discussion 467-8.
Jones WB, et al. Clinical Results Using Bioabsorbable Staple Line Reinforcement for Circular Staplers. Am Surg. 2008;74(6):462-7; discussion 467-8. PubMed PMID: 18556986.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical results using bioabsorbable staple line reinforcement for circular staplers. AU - Jones,Wesley B, AU - Myers,Katherine M, AU - Traxler,L Brannon, AU - Bour,Eric S, PY - 2008/6/18/pubmed PY - 2008/7/4/medline PY - 2008/6/18/entrez SP - 462-7; discussion 467-8 JF - The American surgeon JO - Am Surg VL - 74 IS - 6 N2 - Although linear surgical staple line reinforcement has been shown to increase anastomotic tensile strength in animal models and reduce the incidence of staple line bleeding and anastomotic leaks in colorectal surgery, the benefits of staple line reinforcement on circular stapled anastomoses in bariatric surgery remain unreported in the literature. The purpose if this study was to compare the incidence of anastomotic bleeding, leak, and stricture in patients undergoing laparoscopic gastric bypass with circular staple line reinforcements with those with no circular staple line reinforcements. Since May 2006, 138 consecutive patients (Group B) have undergone laparoscopic Roux-en-Y divided gastric bypass with a 25-mm circular stapled gastrojejunal anastomosis using GORE SEAMGUARD bioabsorbable circular staple line reinforcement (CBSG) with a mean follow up of 9 months. The incidence of anastomotic bleeding, leak, and stricture was compared with 255 similar patients (Group A) who underwent surgery before May 2006 without gastrojejunal reinforcement with a mean follow up of 22 months. The rates of anastomotic bleeding, leak, and stricture for Group B versus Group A were 0.7 per cent versus 1.1 per cent (P = 0.64); 0.7 per cent versus 1.9 per cent (P = 0.34); and 0.7 per cent versus 9.3 per cent (P = 0.0005), respectively. The use of CBSG reduced the incidence of anastomotic stricture by 93 per cent and the incidence of a composite end point of all anastomotic complications by 85 per cent. Our results indicate that the use of circular staple line reinforcement at the gastrojejunal anastomosis in patients undergoing laparoscopic gastric bypass significantly decreases the incidence of anastomotic stricture and a composite end point of all anastomotic complications. On this basis, strong consideration should be given to the routine use of CBSG staple line reinforcement in patients undergoing laparoscopic divided gastric bypass with a circular stapled gastrojejunal anastomosis. SN - 0003-1348 UR - https://www.unboundmedicine.com/medline/citation/18556986/Clinical_results_using_bioabsorbable_staple_line_reinforcement_for_circular_staplers_ L2 - https://medlineplus.gov/weightlosssurgery.html DB - PRIME DP - Unbound Medicine ER -