BACKGROUND: The two basic techniques available in which to perform the gastrojejunal (GJ) anastomosis during a laparoscopic Roux-en-Y gastric bypass (LRYGBP) are stapled and handsewn. Few outcomes differences have been noted between the two to recommend one as a superior approach. We present our findings in comparison of the two methods. METHODS: This is a retrospective review of all patients who underwent LRYGBP at a single institution during a 3-year period. The two different techniques that were used were a linear stapled and handsewn anastomosis with an anastomotic diameter of 18 mm. The groups were compared for postoperative complications, including stricture, anastomotic leak, and the need for early reoperation. All patients were followed up for a minimum period of 8 months. RESULTS: A total of 222 patients were analyzed after excluding 4 patients: 3 for revisional surgery and 1 for conversion to open. There were 99 patients in the stapled group and 123 in the handsewn group. In both groups, patients were predominantly female. The average age was 42.63 in the stapled group and 44.33 in the handsewn group (P = 0.218). Body mass index was 48.23 in the stapled group and 47.91 in the handsewn group (P = 0.733). Stricture rate in the stapled group was 10.1% (10/99) and 4.1% (5/123) in the handsewn group (P = 0.076). Four patients from the stapled group (4.08%) and six from the handsewn group (4.88%) needed early reoperation. One patient in each group had a GJ anastomotic leak (0.9%). There were no deaths. CONCLUSIONS: The incidence of anastomotic stricture tends to be lower with a handsewn technique with lower operative time. No difference was appreciated in the anastomotic leak or reexploration rate with either technique.
BACKGROUND: The two basic techniques available in which to perform the gastrojejunal (GJ) anastomosis during a laparoscopic Roux-en-Y gastric bypass (LRYGBP) are stapled and handsewn. Few outcomes differences have been noted between the two to recommend one as a superior approach. We present our findings in comparison of the two methods. METHODS: This is a retrospective review of all patients who underwent LRYGBP at a single institution during a 3-year period. The two different techniques that were used were a linear stapled and handsewn anastomosis with an anastomotic diameter of 18 mm. The groups were compared for postoperative complications, including stricture, anastomotic leak, and the need for early reoperation. All patients were followed up for a minimum period of 8 months. RESULTS: A total of 222 patients were analyzed after excluding 4 patients: 3 for revisional surgery and 1 for conversion to open. There were 99 patients in the stapled group and 123 in the handsewn group. In both groups, patients were predominantly female. The average age was 42.63 in the stapled group and 44.33 in the handsewn group (P = 0.218). Body mass index was 48.23 in the stapled group and 47.91 in the handsewn group (P = 0.733). Stricture rate in the stapled group was 10.1% (10/99) and 4.1% (5/123) in the handsewn group (P = 0.076). Four patients from the stapled group (4.08%) and six from the handsewn group (4.88%) needed early reoperation. One patient in each group had a GJ anastomotic leak (0.9%). There were no deaths. CONCLUSIONS: The incidence of anastomotic stricture tends to be lower with a handsewn technique with lower operative time. No difference was appreciated in the anastomotic leak or reexploration rate with either technique.
Authors: Lars Sjöström; Anna-Karin Lindroos; Markku Peltonen; Jarl Torgerson; Claude Bouchard; Björn Carlsson; Sven Dahlgren; Bo Larsson; Kristina Narbro; Carl David Sjöström; Marianne Sullivan; Hans Wedel Journal: N Engl J Med Date: 2004-12-23 Impact factor: 91.245
Authors: Juan Carlos Ruiz-de-Adana; Julio López-Herrero; Alberto Hernández-Matías; Laura Colao-Garcia; Jose-Manuel Muros-Bayo; Agustín Bertomeu-Garcia; Manuel Limones-Esteban Journal: Obes Surg Date: 2008-05-06 Impact factor: 4.129
Authors: Paul A Thodiyil; Panduranga Yenumula; Tomasz Rogula; Piotr Gorecki; Bashar Fahoum; William Gourash; Ramesh Ramanathan; Samer G Mattar; Dilip Shinde; Vincent C Arena; Leslie Wise; Philip Schauer Journal: Ann Surg Date: 2008-11 Impact factor: 12.969
Authors: Juan Carlos Ruiz de Adana; Alberto Hernández Matías; Miguel Hernández Bartolomé; Israel Manzanedo Romero; Raquel Leon Ledesma; Ainhoa Valle Rubio; Julio López Herrero; Manuel Limones Esteban Journal: Obes Surg Date: 2009-06-26 Impact factor: 4.129
Authors: Carmen L Mueller; Timothy D Jackson; Todd Swanson; Kristen Pitzul; Chris Daigle; Todd Penner; David R Urbach; Allan Okrainec Journal: Obes Surg Date: 2013-08 Impact factor: 4.129