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Year 2018, Volume: 35 Issue: 3, 245 - 249, 01.05.2018

Abstract

References

  • 1. World Health Organization (WHO), "Data and Statistics on Obesity". [cited 2016 December 9]; Available from: http://www.euro.who.int/en/health-topics/ noncommunicable-diseases/obesity/data-and-statistics.
  • 2. Angrisani L, Santonicola A, Iovino P, Formisano G, Buchwald H, Scopinaro N. Bariatric Surgery Worldwide 2013. Obes Surg 2015;25:1822-32.
  • 3. Regan JP, Inabnet WB, Gagner M, Pomp A. Early experience with two-stage laparoscopic Roux-en-Y gastric bypass as an alternative in the super-super obese patient. Obes Surg 2003;13:861-4.
  • 4. Lim DM, Taller J, Bertucci W, Riffenburgh RH, O'Leary J, Wisbach G. Comparison of laparoscopic sleeve gastrectomy to laparoscopic Roux-en-Y gastric bypass for morbid obesity in a military institution. Surg Obes Relat Dis 2014;10:269-76.
  • 5. Zhang N, Maffei A, Cerabona T, Pahuja A, Omana J, Kaul A. Reduction in obesityrelated comorbidities: is gastric bypass better than sleeve gastrectomy? Surg Endosc 2013;27:1273-80.
  • 6. Genc V, Sulaimanov M, Kırımker EO, Sevim Y, Ensari C. The use of porcine acellular dermal matrix for management of gastrocutaneous fistula after laparoscopic sleeve gastrectomy. J Laparoendosc Adv Surg Tech A 2015;25:401-5.
  • 7. Aurora AR, Khaitan L, Saber AA. Sleeve gastrectomy and the risk of leak: a systematic analysis of 4.888 patients. Surg Endosc 2012;26:1509-15.
  • 8. Tan JT, Kariyawasam S, Wijeratne T, Chandraratna HS. Diagnosis and management of gastric leaks after laparoscopic sleeve gastrectomy for morbid obesity. Obes Surg 2010;20:403-9.
  • 9. van Rutte PW, Naagen BJ, Spek M, Jakimowicz JJ, Nienhuijs SW, Gastric Wall Thickness in Sleeve Gastrectomy Patients: Thickness Variation of the Gastric Wall. Surg Technol Int 2015;27:123-8.
  • 10. Kuzu MA, Köksoy C, Kale IT, Tanik A, Terzi C, Elhan AH. Reperfusion injury delays healing of intestinal anastomosis in a rat. Am J Surg 1998;176:348-51.
  • 11. Jamall IS, Finelli VN, Que Hee SS. A simple method to determine nanogram levels of 4-hydroxyproline in biological tissues. Anal Biochem 1981;112:70-5.
  • 12. Sidney Siegel NJCJ. The Friedman Two-Way Analysis of Variance by Ranks. in Nonparametric Statistics for the Behavioral Sciences. New York: 1988, McGraw-Hill Inc; 1988:174-83.
  • 13. Atkins ER, Preen DB, Jarman C, Cohen LD. Improved obesity reduction and comorbidity resolution in patients treated with 40-French bougie versus 50-French bougie four years after laparoscopic sleeve gastrectomy. Analysis of 294 patients. Obes Surg 2012;22:97-104.
  • 14. Abd Ellatif ME, Abdallah E, Askar W, Thabet W, Aboushady M, Abbas AE, et al. Long term predictors of success after laparoscopic sleeve gastrectomy. Int J Surg 2014;12:504-8.
  • 15. Parikh M, Gagner M, Heacock L, Strain G, Dakin G, Pomp A. Laparoscopic sleeve gastrectomy: does bougie size affect mean %EWL? Short-term outcomes. Surg Obes Relat Dis 2008;4:528-33.
  • 16. Cal P, Deluca L, Jakob T, Fernández E. Laparoscopic sleeve gastrectomy with 27 versus 39 Fr bougie calibration: a randomized controlled trial. Surg Endosc 2016;30:1812-5.
  • 17. Yuval JB, Mintz Y, Cohen MJ, Rivkind AI, Elazary R. The effects of bougie caliber on leaks and excess weight loss following laparoscopic sleeve gastrectomy. Is there an ideal bougie size? Obes Surg 2013;23:1685-91.
  • 18. Parikh M, Issa R, McCrillis A, Saunders JK, Ude-Welcome A, Gagner M. Surgical strategies that may decrease leak after laparoscopic sleeve gastrectomy: a systematic review and meta-analysis of 9991 cases. Ann Surg 2013;257:231-7.
  • 19. Gomes M, Ramacciotti E, Miranda F Jr, Henriques AC, Fagundes DJ. Vascular flow of the gastric fundus after arterial devascularization: an experimental study. J Surg Res 2009;152:128-34.
  • 20. Saber AA, Azar N, Dekal M, Abdelbaki TN. Computed tomographic scan mapping of gastric wall perfusion and clinical implications. Am J Surg 2015;209:999-1006.
  • 21. Natoudi M, Theodorou D, Papalois A, Drymousis P, Alevizos L, Katsaragakis S, et al. Does tissue ischemia actually contribute to leak after sleeve gastrectomy? An experimental study. Obes Surg 2014;24:675-83.
  • 22. Sapala JA, Wood MH, Schuhknecht MP. Anastomotic leak prophylaxis using a vaporheated fibrin sealant: report on 738 gastric bypass patients. Obes Surg 2004;14:35-42.
  • 23. Liu CD, Glantz GJ, Livingston EH. Fibrin glue as a sealant for high-risk anastomosis in surgery for morbid obesity. Obes Surg 2003;13:45-8.
  • 24. Nguyen NT, Nguyen CT, Stevens CM, Steward E, Paya M. The efficacy of fibrin sealant in prevention of anastomotic leak after laparoscopic gastric bypass. J Surg Res 2004;122:218-24

The Effects of Bougie Diameters on Tissue Oxygen Levels After Sleeve Gastrectomy: A Randomized Experimental Trial

Year 2018, Volume: 35 Issue: 3, 245 - 249, 01.05.2018

Abstract

Staple line leak is one of the most frequent and serious complications of laparoscopic sleeve gastrectomy. This study aims to evaluate the effects of different bougie diameters on tissue oxygen partial pressure (PtO2) at the esophagogastric junction after sleeve gastrectomy. The use of narrower bougie along with fibrin sealant has not had a negative effect on tissue perfusion and wound healing. Background: Staple-line leak is the most frightening complication of laparoscopic sleeve gastrectomy and several predisposing factors such as using improper staple sizes regardless of gastric wall thickness, narrower bougie diameter and ischemia of the staple line are asserted. Aims: To evaluate the effects of different bougie diameters on tissue oxygen partial pressure at the esophagogastric junction after sleeve gastrectomy. Study Design: A randomized and controlled animal experiment with 1:1:1:1 allocation ratio. Methods: Thirty-two male Wistar Albino rats were randomly divided into 4 groups of 8 each. While 12-Fr bougies were used in groups 1 and 3, 8-Fr bougies were used in groups 2 and 4. Fibrin sealant application was also carried out around the gastrectomy line after sleeve gastrectomy in groups 3 and 4. Burst pressure of gastrectomy line, tissue oxygen partial pressure and hydroxyproline levels at the esophagogastric junction were measured and compared among groups. Results: Mortality was detected in 2 out of 32 rats (6.25%) and one of them was in group 2 and the cause of this mortality was gastric leak. Gastric leak was detected in 2 out of 32 rats (6.25%). There was no significant difference in terms of burst pressures, tissue oxygen partial pressure and tissue hydroxyproline levels among the 4 groups. Conclusion: The use of narrower bougie along with fibrin sealant has not had a negative effect on tissue perfusion and wound healing.

References

  • 1. World Health Organization (WHO), "Data and Statistics on Obesity". [cited 2016 December 9]; Available from: http://www.euro.who.int/en/health-topics/ noncommunicable-diseases/obesity/data-and-statistics.
  • 2. Angrisani L, Santonicola A, Iovino P, Formisano G, Buchwald H, Scopinaro N. Bariatric Surgery Worldwide 2013. Obes Surg 2015;25:1822-32.
  • 3. Regan JP, Inabnet WB, Gagner M, Pomp A. Early experience with two-stage laparoscopic Roux-en-Y gastric bypass as an alternative in the super-super obese patient. Obes Surg 2003;13:861-4.
  • 4. Lim DM, Taller J, Bertucci W, Riffenburgh RH, O'Leary J, Wisbach G. Comparison of laparoscopic sleeve gastrectomy to laparoscopic Roux-en-Y gastric bypass for morbid obesity in a military institution. Surg Obes Relat Dis 2014;10:269-76.
  • 5. Zhang N, Maffei A, Cerabona T, Pahuja A, Omana J, Kaul A. Reduction in obesityrelated comorbidities: is gastric bypass better than sleeve gastrectomy? Surg Endosc 2013;27:1273-80.
  • 6. Genc V, Sulaimanov M, Kırımker EO, Sevim Y, Ensari C. The use of porcine acellular dermal matrix for management of gastrocutaneous fistula after laparoscopic sleeve gastrectomy. J Laparoendosc Adv Surg Tech A 2015;25:401-5.
  • 7. Aurora AR, Khaitan L, Saber AA. Sleeve gastrectomy and the risk of leak: a systematic analysis of 4.888 patients. Surg Endosc 2012;26:1509-15.
  • 8. Tan JT, Kariyawasam S, Wijeratne T, Chandraratna HS. Diagnosis and management of gastric leaks after laparoscopic sleeve gastrectomy for morbid obesity. Obes Surg 2010;20:403-9.
  • 9. van Rutte PW, Naagen BJ, Spek M, Jakimowicz JJ, Nienhuijs SW, Gastric Wall Thickness in Sleeve Gastrectomy Patients: Thickness Variation of the Gastric Wall. Surg Technol Int 2015;27:123-8.
  • 10. Kuzu MA, Köksoy C, Kale IT, Tanik A, Terzi C, Elhan AH. Reperfusion injury delays healing of intestinal anastomosis in a rat. Am J Surg 1998;176:348-51.
  • 11. Jamall IS, Finelli VN, Que Hee SS. A simple method to determine nanogram levels of 4-hydroxyproline in biological tissues. Anal Biochem 1981;112:70-5.
  • 12. Sidney Siegel NJCJ. The Friedman Two-Way Analysis of Variance by Ranks. in Nonparametric Statistics for the Behavioral Sciences. New York: 1988, McGraw-Hill Inc; 1988:174-83.
  • 13. Atkins ER, Preen DB, Jarman C, Cohen LD. Improved obesity reduction and comorbidity resolution in patients treated with 40-French bougie versus 50-French bougie four years after laparoscopic sleeve gastrectomy. Analysis of 294 patients. Obes Surg 2012;22:97-104.
  • 14. Abd Ellatif ME, Abdallah E, Askar W, Thabet W, Aboushady M, Abbas AE, et al. Long term predictors of success after laparoscopic sleeve gastrectomy. Int J Surg 2014;12:504-8.
  • 15. Parikh M, Gagner M, Heacock L, Strain G, Dakin G, Pomp A. Laparoscopic sleeve gastrectomy: does bougie size affect mean %EWL? Short-term outcomes. Surg Obes Relat Dis 2008;4:528-33.
  • 16. Cal P, Deluca L, Jakob T, Fernández E. Laparoscopic sleeve gastrectomy with 27 versus 39 Fr bougie calibration: a randomized controlled trial. Surg Endosc 2016;30:1812-5.
  • 17. Yuval JB, Mintz Y, Cohen MJ, Rivkind AI, Elazary R. The effects of bougie caliber on leaks and excess weight loss following laparoscopic sleeve gastrectomy. Is there an ideal bougie size? Obes Surg 2013;23:1685-91.
  • 18. Parikh M, Issa R, McCrillis A, Saunders JK, Ude-Welcome A, Gagner M. Surgical strategies that may decrease leak after laparoscopic sleeve gastrectomy: a systematic review and meta-analysis of 9991 cases. Ann Surg 2013;257:231-7.
  • 19. Gomes M, Ramacciotti E, Miranda F Jr, Henriques AC, Fagundes DJ. Vascular flow of the gastric fundus after arterial devascularization: an experimental study. J Surg Res 2009;152:128-34.
  • 20. Saber AA, Azar N, Dekal M, Abdelbaki TN. Computed tomographic scan mapping of gastric wall perfusion and clinical implications. Am J Surg 2015;209:999-1006.
  • 21. Natoudi M, Theodorou D, Papalois A, Drymousis P, Alevizos L, Katsaragakis S, et al. Does tissue ischemia actually contribute to leak after sleeve gastrectomy? An experimental study. Obes Surg 2014;24:675-83.
  • 22. Sapala JA, Wood MH, Schuhknecht MP. Anastomotic leak prophylaxis using a vaporheated fibrin sealant: report on 738 gastric bypass patients. Obes Surg 2004;14:35-42.
  • 23. Liu CD, Glantz GJ, Livingston EH. Fibrin glue as a sealant for high-risk anastomosis in surgery for morbid obesity. Obes Surg 2003;13:45-8.
  • 24. Nguyen NT, Nguyen CT, Stevens CM, Steward E, Paya M. The efficacy of fibrin sealant in prevention of anastomotic leak after laparoscopic gastric bypass. J Surg Res 2004;122:218-24
There are 24 citations in total.

Details

Other ID JA48MR58RC
Journal Section Research Article
Authors

Can Konca This is me

Ali Abbas Yılmaz This is me

Süleyman Utku Çelik This is me

Selami İlgaz Kayılıoğlu This is me

Özge Tuğçe Paşaoğlu This is me

Halil Arda Ceylan This is me

Volkan Genç This is me

Publication Date May 1, 2018
Published in Issue Year 2018 Volume: 35 Issue: 3

Cite

APA Konca, C., Yılmaz, A. A., Çelik, S. U., Kayılıoğlu, S. İ., et al. (2018). The Effects of Bougie Diameters on Tissue Oxygen Levels After Sleeve Gastrectomy: A Randomized Experimental Trial. Balkan Medical Journal, 35(3), 245-249.
AMA Konca C, Yılmaz AA, Çelik SU, Kayılıoğlu Sİ, Paşaoğlu ÖT, Ceylan HA, Genç V. The Effects of Bougie Diameters on Tissue Oxygen Levels After Sleeve Gastrectomy: A Randomized Experimental Trial. Balkan Medical Journal. May 2018;35(3):245-249.
Chicago Konca, Can, Ali Abbas Yılmaz, Süleyman Utku Çelik, Selami İlgaz Kayılıoğlu, Özge Tuğçe Paşaoğlu, Halil Arda Ceylan, and Volkan Genç. “The Effects of Bougie Diameters on Tissue Oxygen Levels After Sleeve Gastrectomy: A Randomized Experimental Trial”. Balkan Medical Journal 35, no. 3 (May 2018): 245-49.
EndNote Konca C, Yılmaz AA, Çelik SU, Kayılıoğlu Sİ, Paşaoğlu ÖT, Ceylan HA, Genç V (May 1, 2018) The Effects of Bougie Diameters on Tissue Oxygen Levels After Sleeve Gastrectomy: A Randomized Experimental Trial. Balkan Medical Journal 35 3 245–249.
IEEE C. Konca, A. A. Yılmaz, S. U. Çelik, S. İ. Kayılıoğlu, Ö. T. Paşaoğlu, H. A. Ceylan, and V. Genç, “The Effects of Bougie Diameters on Tissue Oxygen Levels After Sleeve Gastrectomy: A Randomized Experimental Trial”, Balkan Medical Journal, vol. 35, no. 3, pp. 245–249, 2018.
ISNAD Konca, Can et al. “The Effects of Bougie Diameters on Tissue Oxygen Levels After Sleeve Gastrectomy: A Randomized Experimental Trial”. Balkan Medical Journal 35/3 (May 2018), 245-249.
JAMA Konca C, Yılmaz AA, Çelik SU, Kayılıoğlu Sİ, Paşaoğlu ÖT, Ceylan HA, Genç V. The Effects of Bougie Diameters on Tissue Oxygen Levels After Sleeve Gastrectomy: A Randomized Experimental Trial. Balkan Medical Journal. 2018;35:245–249.
MLA Konca, Can et al. “The Effects of Bougie Diameters on Tissue Oxygen Levels After Sleeve Gastrectomy: A Randomized Experimental Trial”. Balkan Medical Journal, vol. 35, no. 3, 2018, pp. 245-9.
Vancouver Konca C, Yılmaz AA, Çelik SU, Kayılıoğlu Sİ, Paşaoğlu ÖT, Ceylan HA, Genç V. The Effects of Bougie Diameters on Tissue Oxygen Levels After Sleeve Gastrectomy: A Randomized Experimental Trial. Balkan Medical Journal. 2018;35(3):245-9.