Abstract
Background: There is no consensus on the ideal gastrojejunostomy anastomosis (GJA) technique in laparoscopic Roux-en-Y gastric bypass (LRYGB). We reviewed our experience with three GJA techniques (hand-sewn (HSA), linear-stapled (LSA), and 25-mm circular-stapled (CSA)) to determine which anastomosis technique is associated with the lowest early (60-day) anastomotic complication rates. Methods: From November 2004 through December 2009, 882 consecutive patients underwent LRYGB using three GJA techniques: HSA, LSA, and CSA. All patients had a minimum of 2 months follow-up. Records were reviewed for postoperative gastrojejunostomy leak, stricture, and marginal ulcer, and these early complications were classified according to anastomosis technique. Multivariate analysis was performed to determine associations between complications and anastomosis technique. Results: Preoperative demographics, length of hospital stay, and postoperative follow-up did not differ between the three groups. The majority of patients underwent LSA (n=514, 61.6%) followed by HSA (n=180, 21.6%) and CSA (n=140, 16.8%). Using multivariate analysis, there were no statistically significant differences in the rates of leak (LSA 1.0%, HSA 1.1%, CSA 0.0%, p=0.480), stricture (LSA 6.0%, HSA 6.1%, CSA 4.3%, p=0.657), or marginal ulcer (LSA 8.0%, HSA 7.7%, CSA 3.6%, p=0.180). Conclusions: The three techniques can be used safely with a low complication rate. Our data do not identify a superior anastomosis technique.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1671-1675 |
| Number of pages | 5 |
| Journal | Obesity Surgery |
| Volume | 21 |
| Issue number | 11 |
| DOIs | |
| State | Published - Nov 2011 |
| Externally published | Yes |
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Keywords
- Anastomoses
- Bariatric surgery
- Stapled
- Technique
ASJC Scopus subject areas
- Surgery
- Endocrinology, Diabetes and Metabolism
- Nutrition and Dietetics
Cite this
Comparison of hand-sewn, linear-stapled, and circular-stapled gastrojejunostomy in laparoscopic Roux-en-Y gastric bypass. / Bendewald, Frank P.; Choi, Jennifer N.; Blythe, Lorie S.; Selzer, Don J.; Ditslear, John H.; Mattar, Samer.
In: Obesity Surgery, Vol. 21, No. 11, 11.2011, p. 1671-1675.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Comparison of hand-sewn, linear-stapled, and circular-stapled gastrojejunostomy in laparoscopic Roux-en-Y gastric bypass
AU - Bendewald, Frank P.
AU - Choi, Jennifer N.
AU - Blythe, Lorie S.
AU - Selzer, Don J.
AU - Ditslear, John H.
AU - Mattar, Samer
PY - 2011/11
Y1 - 2011/11
N2 - Background: There is no consensus on the ideal gastrojejunostomy anastomosis (GJA) technique in laparoscopic Roux-en-Y gastric bypass (LRYGB). We reviewed our experience with three GJA techniques (hand-sewn (HSA), linear-stapled (LSA), and 25-mm circular-stapled (CSA)) to determine which anastomosis technique is associated with the lowest early (60-day) anastomotic complication rates. Methods: From November 2004 through December 2009, 882 consecutive patients underwent LRYGB using three GJA techniques: HSA, LSA, and CSA. All patients had a minimum of 2 months follow-up. Records were reviewed for postoperative gastrojejunostomy leak, stricture, and marginal ulcer, and these early complications were classified according to anastomosis technique. Multivariate analysis was performed to determine associations between complications and anastomosis technique. Results: Preoperative demographics, length of hospital stay, and postoperative follow-up did not differ between the three groups. The majority of patients underwent LSA (n=514, 61.6%) followed by HSA (n=180, 21.6%) and CSA (n=140, 16.8%). Using multivariate analysis, there were no statistically significant differences in the rates of leak (LSA 1.0%, HSA 1.1%, CSA 0.0%, p=0.480), stricture (LSA 6.0%, HSA 6.1%, CSA 4.3%, p=0.657), or marginal ulcer (LSA 8.0%, HSA 7.7%, CSA 3.6%, p=0.180). Conclusions: The three techniques can be used safely with a low complication rate. Our data do not identify a superior anastomosis technique.
AB - Background: There is no consensus on the ideal gastrojejunostomy anastomosis (GJA) technique in laparoscopic Roux-en-Y gastric bypass (LRYGB). We reviewed our experience with three GJA techniques (hand-sewn (HSA), linear-stapled (LSA), and 25-mm circular-stapled (CSA)) to determine which anastomosis technique is associated with the lowest early (60-day) anastomotic complication rates. Methods: From November 2004 through December 2009, 882 consecutive patients underwent LRYGB using three GJA techniques: HSA, LSA, and CSA. All patients had a minimum of 2 months follow-up. Records were reviewed for postoperative gastrojejunostomy leak, stricture, and marginal ulcer, and these early complications were classified according to anastomosis technique. Multivariate analysis was performed to determine associations between complications and anastomosis technique. Results: Preoperative demographics, length of hospital stay, and postoperative follow-up did not differ between the three groups. The majority of patients underwent LSA (n=514, 61.6%) followed by HSA (n=180, 21.6%) and CSA (n=140, 16.8%). Using multivariate analysis, there were no statistically significant differences in the rates of leak (LSA 1.0%, HSA 1.1%, CSA 0.0%, p=0.480), stricture (LSA 6.0%, HSA 6.1%, CSA 4.3%, p=0.657), or marginal ulcer (LSA 8.0%, HSA 7.7%, CSA 3.6%, p=0.180). Conclusions: The three techniques can be used safely with a low complication rate. Our data do not identify a superior anastomosis technique.
KW - Anastomoses
KW - Bariatric surgery
KW - Stapled
KW - Technique
UR - http://www.scopus.com/inward/record.url?scp=84155167855&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84155167855&partnerID=8YFLogxK
U2 - 10.1007/s11695-011-0470-6
DO - 10.1007/s11695-011-0470-6
M3 - Article
C2 - 21739350
AN - SCOPUS:84155167855
VL - 21
SP - 1671
EP - 1675
JO - Obesity Surgery
JF - Obesity Surgery
SN - 0960-8923
IS - 11
ER -