title: Short-term outcomes of sleeve gastrectomy for morbid obesity: does staple line reinforcement matter?
abstract: BACKGROUND
  Stand-alone laparoscopic sleeve gastrectomy (LSG) has been found to be effective in producing weight loss but few large, one-center LSG series have been reported. Gastric leakage from the staple line is a life-threatening complication of LSG, but there is controversy about whether buttressing the staple line with a reinforcement material will reduce leaks. We describe a single-center, 518-patient series of LSG procedures in which a synthetic buttressing material (GORE® SEAMGUARD® Bioabsorbable Staple Line Reinforcement) was used in the most recently treated patients.
  
  
  METHODS
  We retrospectively reviewed the medical records of all patients who underwent LSG in our unit between September 2007 and December 2011. Patients treated before August 2009 did not receive the staple line reinforcement material (n = 186), whereas all patients treated afterward did (n = 332).
  
  
  RESULTS
  The percentages of excess weight loss in the 518 patients (mean age, 41 years; 82% female; mean preoperative body mass index, 44 kg/m(2)) were 67% (79% follow-up rate) at 6 months postoperatively, 81% (64%) at 1 year, and 84% (30%) at 2 years. Type 2 diabetes resolved in 71 % of patients (91/128). Patients given reinforcement material had baseline characteristics similar to those in the no-reinforcement-material group, but had no postoperative staple line leaks or bleeding. The no-reinforcement group had three leaks (p = 0.045) and one case of bleeding.
  
  
  CONCLUSIONS
  LSG resulted in substantial short-term weight loss. Use of the bioabsorbable staple line reinforcement material may decrease leaks after LSG.
authors.affiliation: The Life Weight Loss Centre, Level 4, 171 Bigge Street, Liverpool, NSW, 2170, Australia, ekdurmush@gmail.com.
authors.forename: Ertugrul Kemal
authors.initials: EK
authors.lastname: Durmush
authors.forename: Goktug
authors.initials: G
authors.lastname: Ermerak
authors.forename: Deniz
authors.initials: D
authors.lastname: Durmush
mesh_terms: D000328:Adult; D057868:Anastomotic Leak / Q000517:prevention & control*; D001672:Biocompatible Materials; D015992:Body Mass Index; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000009:adverse effects / Q000379:methods; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D012189:Retrospective Studies; D017792:Surgical Stapling / Q000295:instrumentation / Q000379:methods*; D016896:Treatment Outcome; D015431:Weight Loss
chemical_list: D001672:Biocompatible Materials