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  1. Fulltext Staple-line leak post primary sleeve gastrectomy. A two patient case series and literature review
    Loo GH, Rajan R, Nik Mahmood NRK
    Ann Med Surg (Lond), 2019 Aug;44:72-76.
    PMID: 31321031 DOI: 10.1016/j.amsu.2019.06.014
    There is an increasing trend in the number of bariatric surgeries performed worldwide, partly because bariatric surgery is the most effective treatment for morbid obesity. Sleeve gastrectomy (SG) remains the most common bariatric surgery procedure performed, representing more than 50% of all primary bariatric interventions. Major surgical complications of SG include staple-line bleeding, leaking, and stenosis. A leak along the staple-line most commonly occurs at the gastroesophageal junction (GOJ). From January 2018 to December 2018, our centre performed 226 bariatric procedures, of which, 97.8% were primary bariatric procedures. The mean age and BMI were 38.7±8.3 years and 44 kg/m2, respectively. Out of the 202 primary SG performed, we encountered two cases of a staple-line leak (0.99%). This is the first reported case series of SG leaks from the Southeast Asia region. A summary of their characteristics, clinical presentation, subsequent management, and the outcome is discussed. Based on the latest available evidence from the literature, several methods may decrease staple-line leaks in SG. These include the use of a bougie size greater than 40 Fr, routine use of methylene blue test during surgery, beginning transection at 2-6 cm from the pylorus, mobilising the fundus before transection, and staying away from the GOJ at the last firing. Other methods include the proper alignment of the staple-line, control of staple-line bleeding, and performing staple-line reinforcement. The management of a staple-line leak remains challenging due to limited systematic, evidence-based literature being available. Therefore, a tailored approach is needed to manage this complication.
    Matched MeSH terms: Surgical Stapling
  2. Fulltext Post pneumonectomy bronchopleural fistula: is it the closure technique or the operative side that really matters?
    Sachithanandan A, Badmanaban B
    Interact Cardiovasc Thorac Surg, 2011 Apr;12(4):562.
    PMID: 21429878 DOI: 10.1510/icvts.2010.251157B
    Matched MeSH terms: Surgical Stapling/adverse effects*
  3. Current surgical treatment of obstructed defecation among selected European opinion leaders in pelvic floor surgery
    Kim M, Meurette G, Ragu R, Lehur PA
    Tech Coloproctol, 2016 Jun;20(6):395-399.
    PMID: 27170284 DOI: 10.1007/s10151-016-1473-z
    BACKGROUND: The aim of this study was to perform a survey on the surgical management of obstructed defecation (OD) across advocated selected coloproctological experts across Europe.

    METHODS: Surgeons from 42 centers of coloproctology in Europe were asked to complete a questionnaire, including seven questions about their past and present operative treatment strategy for patients with OD.

    RESULTS: The questionnaire was completed by 32 experts of pelvic floor surgery in 13 European countries. All but one indicated that they consider surgical treatment for OD. Seventy-four percent of these have been using transanal stapled rectal resection (STARR) and 96 % transabdominal rectopexy. While only 65 %, who have begun performing STARR are still using transanal resection, the technique is still being used by all surgeons performing abdominal procedures. Rectopexy only, STARR only, or both approaches are offered by 52, 3, and 45 % of surgeons, respectively.

    CONCLUSIONS: The use of STARR in the treatment of OD is decreasing among European opinion leaders in the field of pelvic floor surgery, while the application of transabdominal procedures continues.

    Matched MeSH terms: Surgical Stapling
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