Management of Leaks Following Laparoscopic Sleeve Gastrectomy Using Specifically Designed Large Covered Metal Stents.


Journal

Reviews on recent clinical trials
ISSN: 1876-1038
Titre abrégé: Rev Recent Clin Trials
Pays: United Arab Emirates
ID NLM: 101270873

Informations de publication

Date de publication:
2021
Historique:
received: 07 09 2020
revised: 22 12 2020
accepted: 01 01 2021
pubmed: 11 2 2021
medline: 29 10 2021
entrez: 10 2 2021
Statut: ppublish

Résumé

Leaks are the major complication associated with laparoscopic sleeve gastrectomy. The study aimed to assess the efficacy and safety of specifically designed large covered metal stents for the management of post-laparoscopic sleeve gastrectomy leaks. Prospectively collected databases from three Italian Endoscopy Units were reviewed. The primary outcome of the study was to evaluate the clinical success of stents placement, defined as complete resolution of clinical and laboratory signs of sepsis with radiological evidence of leak closure. Secondary outcomes were stent-related adverse events and mortality. Twenty-one patients (67% females, mean age 45 years) were included in the study and a total of 26 stents were placed. Technical success of stent placement was achieved in all cases (100%). Clinical success was observed in 85.5% of patients. Stent-related adverse events occurred in 9 patients (43%), with stent migration as the most frequent complication (33%). Adverse events were more frequently observed in patients who had undergone bariatric surgery prior to laparoscopic sleeve gastrectomy compared to patients without previous surgery (83% et al. 27%, p=0.018). The placement of specifically designed covered metal stents appears to be an effective and safe therapeutic approach for post-laparoscopic sleeve gastrectomy leaks. Stent migration can be a frequent complication.

Sections du résumé

BACKGROUND
Leaks are the major complication associated with laparoscopic sleeve gastrectomy.
OBJECTIVE
The study aimed to assess the efficacy and safety of specifically designed large covered metal stents for the management of post-laparoscopic sleeve gastrectomy leaks.
METHODS
Prospectively collected databases from three Italian Endoscopy Units were reviewed. The primary outcome of the study was to evaluate the clinical success of stents placement, defined as complete resolution of clinical and laboratory signs of sepsis with radiological evidence of leak closure. Secondary outcomes were stent-related adverse events and mortality.
RESULTS
Twenty-one patients (67% females, mean age 45 years) were included in the study and a total of 26 stents were placed. Technical success of stent placement was achieved in all cases (100%). Clinical success was observed in 85.5% of patients. Stent-related adverse events occurred in 9 patients (43%), with stent migration as the most frequent complication (33%). Adverse events were more frequently observed in patients who had undergone bariatric surgery prior to laparoscopic sleeve gastrectomy compared to patients without previous surgery (83% et al. 27%, p=0.018).
CONCLUSION
The placement of specifically designed covered metal stents appears to be an effective and safe therapeutic approach for post-laparoscopic sleeve gastrectomy leaks. Stent migration can be a frequent complication.

Identifiants

pubmed: 33563171
pii: RRCT-EPUB-113972
doi: 10.2174/1574887116666210204142417
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

303-308

Informations de copyright

Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.

Auteurs

Carmelo Luigiano (C)

Unit of Digestive Endoscopy, San Paolo Hospital, Via A. Di Rudiní, 8, 20142 Milano, Italy.

Milena Di Leo (M)

Unit of Digestive Endoscopy, San Paolo Hospital, Via A. Di Rudiní, 8, 20142 Milano, Italy.

Leonardo Henry Eusebi (LH)

Gastroenterology and Endoscopy Unit, Department of Medical and Surgical Sciences, S. Orsola University Hospital, Via G. Massarenti, 9, 40138 Bologna, Italy.

Matteo Barabino (M)

Unit of Hepatobiliopancreatic and Digestive Surgery, Department of Surgery, San Paolo Hospital, University of Milan, Via A. Di Rudiní, 8, 20142 Milano, Italy.

Enrico De Nicola (E)

Unit of Hepatobiliopancreatic and Digestive Surgery, Department of Surgery, San Paolo Hospital, University of Milan, Via A. Di Rudiní, 8, 20142 Milano, Italy.

Marco Giovenzana (M)

Unit of Hepatobiliopancreatic and Digestive Surgery, Department of Surgery, San Paolo Hospital, University of Milan, Via A. Di Rudiní, 8, 20142 Milano, Italy.

Enrico Opocher (E)

Unit of Hepatobiliopancreatic and Digestive Surgery, Department of Surgery, San Paolo Hospital, University of Milan, Via A. Di Rudiní, 8, 20142 Milano, Italy.

Giuseppe Iabichino (G)

Unit of Digestive Endoscopy, San Paolo Hospital, Via A. Di Rudiní, 8, 20142 Milano, Italy.

Maria Angela Palamara (MA)

Unit of Digestive Endoscopy, San Paolo Hospital, Via A. Di Rudiní, 8, 20142 Milano, Italy.

Giuseppa Giacobbe (G)

Unit of Digestive Endoscopy, University of Messina, Hospital "G. Martino", Via Consolare Valeria 2 - 98124 Messina, Italy.

Andrea Tortora (A)

Unit of Digestive Endoscopy, University of Messina, Hospital "G. Martino", Via Consolare Valeria 2 - 98124 Messina, Italy.

Clara Virgilio (C)

Unit of Gastroenterology and Digestive Endoscopy, ARNAS Garibaldi, 95122 Catania, Italy.

Ludovico Abenavoli (L)

Department of Health Sciences, University "Magna Graecia", Viale Europa - 88100 Catanzaro, Italy.

Socrate Pallio (S)

Unit of Digestive Endoscopy, University of Messina, Hospital "G. Martino", Via Consolare Valeria 2 - 98124 Messina, Italy.

Pierluigi Consolo (P)

Unit of Digestive Endoscopy, University of Messina, Hospital "G. Martino", Via Consolare Valeria 2 - 98124 Messina, Italy.

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