title: The effect of serosal suture reinforcement on burst pressure in sleeve gastrectomy specimens.
abstract: OBJECTIVE
  Staple-line leak is a life-threatening complication of laparoscopic sleeve gastrectomy. Reinforcement materials have been reported to lower the risk of staple-line bleeding, but their effects on leak risk have not been elucidated. The aim of this study was to compare the effects of 2 supportive techniques on burst pressures in sleeved gastrectomy specimens.
  
  
  METHODS
  A total of 30 patients who underwent laparoscopic sleeve gastrectomy were evaluated. The resected sleeve gastrectomy specimens were categorized into 3 groups: group 1 had no extra support in the staple-line, group 2 had interrupted serosal suture on the staple-line, and group 3 had serosal suture on staple-line junction points. The endpoint was the first detectable leakage, at which point the leak pressure and anatomic site of the leakage were recorded.
  
  
  RESULTS
  A total of 30 sleeved gastrectomy specimens were included (each group included 10 specimens). There were no differences between groups in terms of age, sex, and body mass index. The leak pressure was significantly higher (56.2±6.4 mm Hg) in group 2 (P<0.01). Leaks occurred significantly more frequently in the staple-line than in the staple-line junction points (P<0.01).
  
  
  CONCLUSIONS
  Interrupted serosal suture significantly increased the burst pressure. Increases in intraluminal pressure are known to be significant in leak etiology. Thus, we concluded that interrupted serosal suture may be beneficial in the prevention of leaks.
authors.affiliation: *Department of Surgery, Antalya Training and Research Hospital, Antalya †Department of Surgery, Faculty of Medicine, Bozok University, Yozgat ‡Department of Surgery, Fatih Sultan Mehmet Training and Research Hospital, İstanbul, Turkey.
authors.forename: Rojbin
authors.initials: R
authors.lastname: Karakoyun
authors.forename: Umut
authors.initials: U
authors.lastname: Gündüz
authors.forename: Nurullah
authors.initials: N
authors.lastname: Bülbüller
authors.forename: Sükrü
authors.initials: S
authors.lastname: Ozdemir
authors.forename: Oktay
authors.initials: O
authors.lastname: Banli
authors.forename: Hasan
authors.initials: H
authors.lastname: Altun
authors.forename: Ramazan
authors.initials: R
authors.lastname: Eryilmaz
mesh_terms: D000328:Adult; D005260:Female; D005743:Gastrectomy / Q000379:methods; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control; D011312:Pressure; D013537:Sutures