Management and outcomes of gastric leak after sleeve gastrectomy: results from the 2010–2020 national registry
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Le résumé fourni par la source
BACKGROUND: Management of gastric leak after sleeve gastrectomy (SG) is challenging due to its unpredictable outcomes. We aimed to summarize the characteristics of SG leaks and analyze interventions and corresponding outcomes in a real-world setting. METHODS: To retrospectively review of 15,721 SG procedures from 2010 to 2020 based on a national registry. A cumulative sum analysis was used to identify a fitting curve of gastric leak rate. The Kaplan-Meier method and log-rank tests were performed to calculate and compare the probabilities of relevant outcomes. The logistic regression analysis was conducted to determine the predictors of acute leaks. RESULTS: A total of 78 cases of SG leaks were collected with an incidence of 0.5% (78/15,721) from this registry (6 patients who had the primary SG in non-participating centers). After accumulating 260 cases in a bariatric surgery center, the leak rate decreased to a stably low value of under 1.17%. The significant differences presented in sex, waist circumference, and the proportion of hypoproteinemia and type 2 diabetes at baseline between patients with SG leak and the whole registry population ( P = 0.005, = 0.026, <0.001, and = 0.001, respectively). Moreover, 83.1% (59/71) of the leakage was near the esophagogastric junction region. Leakage healed in 64 (88.9%, 64/72) patients. The median healing time of acute and non-acute leaks was 5.93 months and 8.12 months, respectively. Acute leak (38/72, 52.8%) was the predominant type with a cumulative reoperation rate >50%, whereas the cumulative healing probability in the patients who required surgical treatment was significantly lower than those requring non-surgical treatment ( P = 0.013). Precise dissection in the His angle area was independently associated with a lower acute leak rate, whereas preservation ≥2 cm distance from the His angle area was an independent risk factor. CONCLUSIONS: Male sex, elevated waist circumference, hypoproteinaemia, and type 2 diabetes are risk factors of gastric leaks after SG. Optimizing surgical techniques, including precise dissection of His angle area and preservation of smaller gastric fundus, should be suggested to prevent acute leaks.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Management and outcomes of gastric leak after sleeve gastrectomy: results from the 2010–2020 national registry
- Date Crossref
- 31/07/2023
- Éditeur
- Ovid Technologies (Wolters Kluwer Health)
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Capital Medical University Department of General Surgery pays non établi dans la noticeUniversité ou école supérieure
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National Clinical Research Center for Digestive Diseases pays non établi dans la noticeÉtablissement de santé
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Beijing Friendship Hospital pays non établi dans la noticeÉtablissement de santé
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Peking University pays non établi dans la noticeUniversité ou école supérieure
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Third People's Hospital of Chengdu Department of General Surgery pays non établi dans la noticeÉtablissement de santé
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Southwest Jiaotong University pays non établi dans la noticeUniversité ou école supérieure
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Nanjing Drum Tower Hospital Department of General Surgery pays non établi dans la noticeÉtablissement de santé
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First Affiliated Hospital of Xi'an Jiaotong University Department of Hepatobiliary Surgery pays non établi dans la noticeÉtablissement de santé
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First Affiliated Hospital of Jinan University Department of Metabolic and Bariatric Surgery pays non établi dans la noticeÉtablissement de santé
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Soochow University Department of General Surgery pays non établi dans la noticeUniversité ou école supérieure
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First Affiliated Hospital of Soochow University pays non établi dans la noticeÉtablissement de santé
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Fudan University Huashan Hospital pays non établi dans la noticeUniversité ou école supérieure
Department of General Surgery — Capital Medical University, National Clinical Research Center for Digestive Diseases et Beijing Friendship Hospital, avec 9 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.