Oversewing staple line of the gastric remnant in gastric bypass reduces postoperative bleeding

胃绕道手术中胃残段缝合线缝合减少术后出血

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作者:G Borjas, M Gonzalez, A Maldonado, A Urdaneta, E Ramos

Background

Roux-en-Y gastric bypass (RYGB) is a surgery with low rate complications. However, it is not exempt from them, and 1-6% suffer complications such as postoperative bleeding. Many intraoperative techniques have been evaluated to reduce postoperative bleeding, like the oversewing or reinforcement of the staple line. This study aims to evaluate the rate of postoperative bleeding in the oversewing of the staple line of the gastric remnant group versus the stapling only group.

Conclusions

Oversewing the staple line of the gastric remnant significantly reduces the incidence of postoperative bleeding regardless of BMI. Being a cost-effective technique compared to others available despite the increase in operating time.

Methods

This is a 2-center, case-control study. We randomly selected two groups who underwent RYGB or OAGB: group A (n = 225) with oversewing from 2019 to 2020 and group B (n = 225) with stapling only between the period of 2017-2018; both groups with similar demographic characteristics.

Results

The overall mean age was 37.39 ± 9.6 years and mean BMI was 41.59 ± 8.6 kg/m2; the postoperative bleeding rate was significantly lower (p < 0,05) in patients with oversewing of the staple line of the gastric remnant. Operative time was shorter for the stapling only group and the difference between the mean operative time was 10.6 min. Conclusions: Oversewing the staple line of the gastric remnant significantly reduces the incidence of postoperative bleeding regardless of BMI. Being a cost-effective technique compared to others available despite the increase in operating time.

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