title: Experience in laparoscopic sleeve gastrectomy for morbidly obese Taiwanese: staple-line reinforcement is important for preventing leakage.
abstract: BACKGROUND
  Laparoscopic sleeve gastrectomy (LSG) is a promising procedure for the surgical treatment of morbid obesity. We report our 2-year experience with LSG and specifically evaluate the importance of staple-line protection to prevent leakage after the laparoscopic procedure.
  
  
  METHODS
  One hundred eighteen consecutive patients with BMI > 30 who underwent LSG from January 2006 to February 2009 were included in our study. There were 88 women and 30 men with a mean age of 33.2 ± 9.6 years and a mean BMI of 38.0 ± 6.4 kg/m(2). The first 40 patients (group 1) underwent the operation without any reinforcement procedure and the other 78 patients received reinforcement of the staple-line (group 2). Data including demographics, hospital stay, blood loss, operative time, complications, excess weight loss percentage (EWL%), and gastrointestinal quality of life index (GIQLI) were collected prospectively for evaluation.
  
  
  RESULTS
  The overall mean operative time was 118.5 ± 37.0 min, mean blood loss was 56.8 ± 56.7 ml, mean hospital stay was 5 ± 3 days. The mean EWL% at 12 and 24 months was 81.5 and 76.0%, respectively. The overall leakage rate was 3.39% (4/118). All leakage occurred in group 1 patients, with a leakage rate of 10% (4/40). Mean preoperative GIQLI was 98.7, and the postoperative GIQLI were 116.4, 115, 112.4, and 97.6 at 3, 6, 12, and 24 months, respectively.
  
  
  CONCLUSIONS
  LSG is an effective obesity treatment to achieve significant weight loss after 24 months. Staple-line reinforcement is strongly recommended for laparoscopic sleeve gastrectomy to decrease complications.
authors.affiliation: Department of Surgery, Min-Sheng General Hospital, Taoyuan City, Taoyuan County, 330, Taiwan, ROC. maxist_ser@hotmail.com
authors.forename: Kong-Han
authors.initials: KH
authors.lastname: Ser
authors.forename: Wei-Jei
authors.initials: WJ
authors.lastname: Lee
authors.forename: Yi-Chih
authors.initials: YC
authors.lastname: Lee
authors.forename: Jung-Chien
authors.initials: JC
authors.lastname: Chen
authors.forename: Yen-Hao
authors.initials: YH
authors.lastname: Su
authors.forename: Shu-Chun
authors.initials: SC
authors.lastname: Chen
mesh_terms: D000328:Adult; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D015992:Body Mass Index; D016009:Chi-Square Distribution; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D009767:Obesity, Morbid / Q000601:surgery*; D011183:Postoperative Complications / Q000517:prevention & control*; D011446:Prospective Studies; D011788:Quality of Life; D017792:Surgical Stapling / Q000379:methods*; D013624:Taiwan; D013997:Time Factors; D016896:Treatment Outcome; D015431:Weight Loss