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Management and outcomes of gastric leak after sleeve gastrectomy:results from the 2010-2020 national registry

Management and outcomes of gastric leak after sleeve gastrectomy: results from the 2010–2020 national registry

作     者:Mengyi Li Na Zeng Yang Liu Xitai Sun Wah Yang Yanjun Liu Zhongqi Mao Qiyuan Yao Xiangwen Zhao Hui Liang Wenhui Lou Chiye Ma Jinghai Song Jianlin Wu Wei Yang Pin Zhang Liyong Zhu Peirong Tian Peng Zhang Zhongtao Zhang for the Greater China Metabolic and Bariatric Surgery Database(GC-MBD)study group 

作者机构:Department of General SurgeryBeijing Friendship HospitalCapital Medical University&National Clinical Research Center for Digestive DiseasesBeijing 100050China School of Public HealthPeking UniversityBeijing 100191China Department of General SurgeryNanjing Drum Tower HospitalNanjingJiangsu 210008China Department of Metabolic and Bariatric SurgeryThe First Affiliated Hospital of Jinan UniversityGuangzhouGuangdong 510630China Center of Gastrointestinal and Minimally Invasive SurgeryDepartment of General SurgeryThe Third People’s Hospital of Chengdu&The Affiliated Hospital of Southwest Jiaotong UniversityChengduSichuan 610014China Department of General SurgeryThe First Affiliated Hospital of Soochow UniversitySuzhouJiangsu 215006China Center for Obesity and Metabolic SurgeryHuashan HospitalFudan UniversityShanghai 200030China Department of Metabolic and Bariatric SurgeryXiaolan People’s Hospital of ZhongshanZhongshanGuangdong 528415China Department of General SurgeryFirst Affiliated Hospital with Nanjing Medical UniversityNanjingJiangsu 226399China Department of General SurgeryZhongshan HospitalShanghai 200032China Department of Gastrointestinal SurgeryDongfang Hospital of ShaghaiShanghai 200120China Department of General SurgeryBeijng HospitalBeijing 100730China Department of Gastrointestinal SurgeryZibo Central HospitalZiboShandong 255020China Department of Hepatobiliary SurgeryFirst Affiliated Hospital of Xi’an Jiaotong UniversityXi’anShaanxi 710061China Department of Bariatric and Metabolic SurgeryShanghai Jiao Tong University affiliated Sixth People’s HospitalShanghai 200233China Department of Gastrointestinal SurgeryThe Third Xiangya Hospital of Central South UniversityChangshaHunan 410013China 不详 

出 版 物:《Chinese Medical Journal》 (中华医学杂志(英文版))

年 卷 期:2023年第136卷第16期

页      面:1967-1976页

核心收录:

学科分类:1002[医学-临床医学] 100210[医学-外科学(含:普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学] 

基  金:ZTZ has received funding from the National Key Technologies R&D Program(No.2015BAI13B09) the Capital’s Funds for Health Improvement and Research(No.2020-1-2021) MYL has received funding from the Beijing Excellent Talents Training Funding Program(No.2018000021469G195) 

主  题:Sleeve gastrectomy Gastric leak National registry 

摘      要:Background:Management of gastric leak after sleeve gastrectomy(SG)is challenging due to its unpredictable *** aimed to summarize the characteristics of SG leaks and analyze interventions and corresponding outcomes in a real-world ***:To retrospectively review of 15,721 SG procedures from 2010 to 2020 based on a national registry.A cumulative sum analysis was used to identify a fitting curve of gastric leak *** Kaplan-Meier method and log-rank tests were performed to calculate and compare the probabilities of relevant *** logistic regression analysis was conducted to determine the predictors of acute ***:A total of 78 cases of SG leaks were collected with an incidence of 0.5%(78/15,721)from this registry(6 patients who had the primary SG in non-participating centers).After accumulating 260 cases in a bariatric surgery center,the leak rate decreased to a stably low value of under 1.17%.The significant differences presented in sex,waist circumference,and the proportion of hypoproteinemia and type 2 diabetes at baseline between patients with SG leak and the whole registry population(P=0.005,=0.026,50%,whereas the cumulative healing probability in the patients who required surgical treatment was significantly lower than those requring non-surgical treatment(P=0.013).Precise dissection in the His angle area was independently associated with a lower acute leak rate,whereas preservation≥2 cm distance from the His angle area was an independent risk ***:Male sex,elevated waist circumference,hypoproteinaemia,and type 2 diabetes are risk factors of gastric leaks after *** surgical

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