Endoscopic Negative Pressure Therapy (ENPT) Is Superior to Stent Therapy for Staple Line Leak After Sleeve Gastrectomy: a Single-Center Cohort Study.

Endoscopic Vacuum therapy Endoscopic negative pressure therapy Sleeve gastrectomy Staple line leak Stent Surgical complications

Journal

Obesity surgery
ISSN: 1708-0428
Titre abrégé: Obes Surg
Pays: United States
ID NLM: 9106714

Informations de publication

Date de publication:
06 2021
Historique:
received: 06 10 2020
accepted: 09 02 2021
revised: 07 02 2021
pubmed: 3 3 2021
medline: 21 5 2021
entrez: 2 3 2021
Statut: ppublish

Résumé

Staple line leak (SLL) is a serious complication after sleeve gastrectomy (SG). Common endoscopic treatment options include self-expandable metallic stent (SEMS), endoscopic internal drainage (EID), and endoscopic closure. The endoscopic negative pressure therapy (ENPT) is a promising treatment option combining temporary sealing of the defect with drainage of the inflammatory bed. In this study, we compare the outcome of ENPT and SEMS for the treatment of SLL following SG. A retrospective cohort of 27 patients (21 females) treated at a single center for SLL after SG was included. ENPT was primary therapy for 14 patients and compared with 13 patients treated primarily using SEMS. ENPT was associated with a significant reduction of hospital stay (19 ± 15.1 vs. 56.69 ± 47.21 days, p = 0.027), reduced duration of endoscopic treatment (9.8 ± 8.6 vs. 44.92 ± 60.98 days, p = 0.009), and shorter transabdominal drain dwell time (15 (5-96) vs. 45 (12-162) days, p = 0.014) when compared to SEMS. Whereas endoscopic management was successful in 12/14 (85.7%) of patients from the ENPT group, SEMS was successful in only 5/13 (38.5%) of patients (p = 0.015). Furthermore, ENPT was associated with a significant reduction of endoscopic adverse events compared with SEMS (14.3% vs. 76.92% p = 0.001). Compared with SEMS, ENPT is effective and safe in treating SLL after SG providing higher success rates, shorter treatment duration, and lower adverse events rates.

Identifiants

pubmed: 33650088
doi: 10.1007/s11695-021-05287-z
pii: 10.1007/s11695-021-05287-z
pmc: PMC8113301
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

2511-2519

Références

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Auteurs

Rami Archid (R)

Department for General, Visceral and Transplant Surgery, Eberhard-Karls-University Hospital, Hoppe-Seyler-Str. 3-5, 72076, Tuebingen, Germany. rami.archid@med.uni-tuebingen.de.

Fateh Bazerbachi (F)

Division of Gastroenterology, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, 02114, USA.

Barham K Abu Dayyeh (BK)

Department of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, 55905, USA.

Felix Hönes (F)

Department for General, Visceral and Transplant Surgery, Eberhard-Karls-University Hospital, Hoppe-Seyler-Str. 3-5, 72076, Tuebingen, Germany.

Suhaib J S Ahmad (SJS)

Milton Keynes University Hospital, Milton Keynes, UK.

Karolin Thiel (K)

Department for General, Visceral and Transplant Surgery, Eberhard-Karls-University Hospital, Hoppe-Seyler-Str. 3-5, 72076, Tuebingen, Germany.

Giorgi Nadiradze (G)

Department for General, Visceral and Transplant Surgery, Eberhard-Karls-University Hospital, Hoppe-Seyler-Str. 3-5, 72076, Tuebingen, Germany.

Alfred Königsrainer (A)

Department for General, Visceral and Transplant Surgery, Eberhard-Karls-University Hospital, Hoppe-Seyler-Str. 3-5, 72076, Tuebingen, Germany.

Dörte Wichmann (D)

Department for General, Visceral and Transplant Surgery, Eberhard-Karls-University Hospital, Hoppe-Seyler-Str. 3-5, 72076, Tuebingen, Germany.

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