Effects and results of fibrin sealant use in 1000 laparoscopic sleeve gastrectomy cases.
Staple-line leakage and bleeding are worrisome and feared postoperative complications after laparoscopic sleeve gastrectomy (LSG) in morbidly obese patients. The purpose of this study was to review clinical evidence following the use of fibrin sealant in standard LSG.



Morbidly obese patients who underwent standard technique of LSG with using fibrin sealant were included in the study. Demographics variables [age, gender, body mass index (kg/m2), and comorbid conditions], the re-admission rate, and postoperative early complications, such as bleeding, staple-line leak, twist and stricture, were evaluated at the follow-up during the postoperative first month.



In total, 1000 patients [586 female (58.6 %)] with a mean age of 42.6 ± 13.6 years underwent LSG. Fibrin sealant was used in all operations. In total, 186 patients (18.6 %) had previous abdominal surgery. The mean operative time was 72 ± 19 min, and the mean hospital stay was 3.2 ± 1.1 days. Only 3 patients (.3 %) experienced bleeding. Staple-line leakage, twist and stricture were not observed. The re-admission rate was .5 %, and no mortalities were noted.



This retrospective study indicates that bariatric surgeons should consider implementing standardized surgical operative technique for reduced postoperative complications in LSG. Fibrin sealant is a reliable and useful tool to reinforce the staple line and may prevent potential twists of the sleeved stomach.
Department of General Surgery, Bezmialem Vakif University, Istanbul, Turkey.
Halil
H
Coskun
Department of General Surgery, Bezmialem Vakif University, Istanbul, Turkey. drerkanyardimci@yahoo.com.|Department of General Surgery, Arnavutkoy State Hospital, Eski Edirne Str, Arvanutkoy, 34275, Istanbul, Turkey. drerkanyardimci@yahoo.com.
Erkan
E
Yardimci
D000328:Adult; D005260:Female; D015718:Fibrin Tissue Adhesive / Q000627:therapeutic use*; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery; D061646:Operative Time; D010359:Patient Readmission / Q000706:statistics & numerical data; D012189:Retrospective Studies
D015718:Fibrin Tissue Adhesive
Fibrin sealant; Reinforcement; Sleeve gastrectomy; Staple line