title: Comparison of staple-line leakage and hemorrhage in patients undergoing laparoscopic sleeve gastrectomy with or without Seamguard.
abstract: Laparoscopic sleeve gastrectomy (LSG) has been recognized as a primary procedure for the surgical management of morbid obesity. Staple-line leaks and hemorrhage are two associated complications. Staple-line buttressing materials have been suggested to decrease these complications. When  used during LSG, few published papers exist that compare the incidence of leak or hemorrhage to that of nonreinforced staple-lines. The purpose of this study was to compare the incidence of leak and hemorrhage in patients who did and did not receive reinforcement with Seamguard (W.L. Gore  & Associates, Flagstaff, AZ). This is a retrospective analysis of patients undergoing LSG. All patients met National Institutes of Health criteria and each had an extensive preoperative evaluation. Data was collected from inpatient and outpatient medical records. Fifty-nine patients received  reinforcement and 80 patients did not. There was no significant difference in mean body mass index, age, or gender make-up between the two groups. The overall incidence of leak was 3.60 per cent. The incidence was 3.39 per cent in patients who received reinforcement and 3.75 per cent in those  who did not. This was not statistically significant. There was no incidence of staple-line hemorrhage in either group. There is no conclusive evidence that Seamguard reduces staple-line leakage or hemorrhage. Studies involving a larger number of patients are necessary before recommending staple-line  reinforcement.
authors.affiliation: Dwight D. Eisenhower Army Medical Center, Department of General Surgery, Fort Gordon, Georgia 30905, USA. te.simon@yahoo.com
authors.forename: Todd E
authors.initials: TE
authors.lastname: Simon
authors.forename: Joshua A
authors.initials: JA
authors.lastname: Scott
authors.forename: Joel R
authors.initials: JR
authors.lastname: Brockmeyer
authors.forename: Robert C
authors.initials: RC
authors.lastname: Rice
authors.forename: James D
authors.initials: JD
authors.lastname: Frizzi
authors.forename: Farah A
authors.initials: FA
authors.lastname: Husain
authors.forename: Yong U
authors.initials: YU
authors.lastname: Choi
mesh_terms: D000328:Adult; D000368:Aged; D057868:Anastomotic Leak / Q000453:epidemiology / Q000209:etiology*; D004868:Equipment Failure; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000009:adverse effects* / Q000379:methods; D006471:Gastrointestinal Hemorrhage / Q000453:epidemiology / Q000209:etiology*; D005845:Georgia / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D010535:Laparoscopy / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D019106:Postoperative Hemorrhage / Q000453:epidemiology / Q000209:etiology*; D012189:Retrospective Studies; D013536:Suture Techniques / Q000009:adverse effects* / Q000295:instrumentation; D055815:Young Adult