Measurement of Stomach Wall Thickness to Guide Staple Selection during Sleeve Gastrectomy
Background Sleeve gastrectomy has been considered a primary bariatric surgery; however, surgeons concerned with staple line leakage often query whether staples selected during stomach resection are of an appropriate size. This study aimed to measure gastric wall thickness using pathology laboratory...
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| Veröffentlicht in: | Obesity surgery 2020-06, Vol.30 (6), p.2140-2146 |
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| creator | Lee, Yoo Jin Kim, You Na Park, Sungsoo |
| description | Background
Sleeve gastrectomy has been considered a primary bariatric surgery; however, surgeons concerned with staple line leakage often query whether staples selected during stomach resection are of an appropriate size. This study aimed to measure gastric wall thickness using pathology laboratory measurements and to identify variables correlated with stomach wall thickness in patients who had undergone laparoscopic sleeve gastrectomy.
Methods
We obtained fresh resected stomach wall specimens from 30 patients. Stomach wall thickness was immediately measured postoperatively, comprising the muscle layer of the antrum, body, and fundus. Results were correlated with body mass index (BMI), age, and sex and with diagnoses of presurgical diabetes, hypertension, hyperlipidemia, and fatty liver.
Results
Stomach wall thickness ranged from 3.4 ± 4.3 mm to 1.0 ± 9.6 mm at the antrum. Except for the whole layer at the body wall, there was no significant correlation between wall thickness and other factors. At the body wall, whole layer wall thickness was found to positively correlate with age, sex, diabetes, and smoking (r = 0.469, − 0.391, 0.396, and 0.349, respectively;
p
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| doi_str_mv | 10.1007/s11695-020-04439-x |
| format | Article |
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Sleeve gastrectomy has been considered a primary bariatric surgery; however, surgeons concerned with staple line leakage often query whether staples selected during stomach resection are of an appropriate size. This study aimed to measure gastric wall thickness using pathology laboratory measurements and to identify variables correlated with stomach wall thickness in patients who had undergone laparoscopic sleeve gastrectomy.
Methods
We obtained fresh resected stomach wall specimens from 30 patients. Stomach wall thickness was immediately measured postoperatively, comprising the muscle layer of the antrum, body, and fundus. Results were correlated with body mass index (BMI), age, and sex and with diagnoses of presurgical diabetes, hypertension, hyperlipidemia, and fatty liver.
Results
Stomach wall thickness ranged from 3.4 ± 4.3 mm to 1.0 ± 9.6 mm at the antrum. Except for the whole layer at the body wall, there was no significant correlation between wall thickness and other factors. At the body wall, whole layer wall thickness was found to positively correlate with age, sex, diabetes, and smoking (r = 0.469, − 0.391, 0.396, and 0.349, respectively;
p
< 0.05 in all patients).
Conclusion
Stomach wall thickness varied among patients who had undergone laparoscopic sleeve gastrectomy according to samples taken at three stomach wall sites. The range in wall thickness was normal, and thus, surgeons need not hesitate in selecting the staple height. Also, our study may be helpful to guide surgeon choice concerning the third or fourth staple around the body area when considering a patient’s independent factors.</description><identifier>ISSN: 0960-8923</identifier><identifier>EISSN: 1708-0428</identifier><identifier>DOI: 10.1007/s11695-020-04439-x</identifier><identifier>PMID: 32062844</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Automotive parts ; Diabetes ; Gastrectomy ; Gastric Fundus - surgery ; Gastrointestinal surgery ; Humans ; Laparoscopy ; Medicine ; Medicine & Public Health ; Obesity, Morbid - surgery ; Original Contributions ; Potassium ; Stomach ; Stomach - diagnostic imaging ; Stomach - surgery ; Surgeons ; Surgery ; Surgical Stapling ; Sutures</subject><ispartof>Obesity surgery, 2020-06, Vol.30 (6), p.2140-2146</ispartof><rights>Springer Science+Business Media, LLC, part of Springer Nature 2020</rights><rights>Springer Science+Business Media, LLC, part of Springer Nature 2020.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c441t-77d371bc05fcaed308235e6f5fae2313f680a79ca6e88d4d4a5668b813cf9cc03</citedby><cites>FETCH-LOGICAL-c441t-77d371bc05fcaed308235e6f5fae2313f680a79ca6e88d4d4a5668b813cf9cc03</cites><orcidid>0000-0001-7444-9490</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s11695-020-04439-x$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s11695-020-04439-x$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32062844$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lee, Yoo Jin</creatorcontrib><creatorcontrib>Kim, You Na</creatorcontrib><creatorcontrib>Park, Sungsoo</creatorcontrib><title>Measurement of Stomach Wall Thickness to Guide Staple Selection during Sleeve Gastrectomy</title><title>Obesity surgery</title><addtitle>OBES SURG</addtitle><addtitle>Obes Surg</addtitle><description>Background
Sleeve gastrectomy has been considered a primary bariatric surgery; however, surgeons concerned with staple line leakage often query whether staples selected during stomach resection are of an appropriate size. This study aimed to measure gastric wall thickness using pathology laboratory measurements and to identify variables correlated with stomach wall thickness in patients who had undergone laparoscopic sleeve gastrectomy.
Methods
We obtained fresh resected stomach wall specimens from 30 patients. Stomach wall thickness was immediately measured postoperatively, comprising the muscle layer of the antrum, body, and fundus. Results were correlated with body mass index (BMI), age, and sex and with diagnoses of presurgical diabetes, hypertension, hyperlipidemia, and fatty liver.
Results
Stomach wall thickness ranged from 3.4 ± 4.3 mm to 1.0 ± 9.6 mm at the antrum. Except for the whole layer at the body wall, there was no significant correlation between wall thickness and other factors. At the body wall, whole layer wall thickness was found to positively correlate with age, sex, diabetes, and smoking (r = 0.469, − 0.391, 0.396, and 0.349, respectively;
p
< 0.05 in all patients).
Conclusion
Stomach wall thickness varied among patients who had undergone laparoscopic sleeve gastrectomy according to samples taken at three stomach wall sites. The range in wall thickness was normal, and thus, surgeons need not hesitate in selecting the staple height. Also, our study may be helpful to guide surgeon choice concerning the third or fourth staple around the body area when considering a patient’s independent factors.</description><subject>Automotive parts</subject><subject>Diabetes</subject><subject>Gastrectomy</subject><subject>Gastric Fundus - surgery</subject><subject>Gastrointestinal surgery</subject><subject>Humans</subject><subject>Laparoscopy</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Obesity, Morbid - surgery</subject><subject>Original Contributions</subject><subject>Potassium</subject><subject>Stomach</subject><subject>Stomach - diagnostic imaging</subject><subject>Stomach - surgery</subject><subject>Surgeons</subject><subject>Surgery</subject><subject>Surgical Stapling</subject><subject>Sutures</subject><issn>0960-8923</issn><issn>1708-0428</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9kE1P4zAQhq0VaCll_8AekCUuXALjjzjOESEoSKA9tCvEyXKdCQSSuNgJov8eQ_mQ9rCn0Wieecd-CPnN4IgBFMeRMVXmGXDIQEpRZi8_yIQVoFPL9RaZQKkg0yUXO2Q3xgcAzhTnP8mO4KC4lnJCbq_RxjFgh_1AfU3ng--su6c3tm3p4r5xjz3GSAdPZ2NTYZrbVZsKtuiGxve0GkPT39F5i_iMdGbjENLEd-s9sl3bNuKvjzolf8_PFqcX2dWf2eXpyVXmpGRDVhSVKNjSQV47i5UAzUWOqs5ri1wwUSsNtiidVah1JStpc6X0UjPh6tI5EFNyuMldBf80YhxM10SHbWt79GM0KU6p9G-mEnrwD_rgx9Cn1yWq1JIVMuVOCd9QLvgYA9ZmFZrOhrVhYN7Em414k8Sbd_HmJS3tf0SPyw6rr5VP0wkQGyCu3oRh-L79n9hXjFWOjQ</recordid><startdate>20200601</startdate><enddate>20200601</enddate><creator>Lee, Yoo Jin</creator><creator>Kim, You Na</creator><creator>Park, Sungsoo</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-7444-9490</orcidid></search><sort><creationdate>20200601</creationdate><title>Measurement of Stomach Wall Thickness to Guide Staple Selection during Sleeve Gastrectomy</title><author>Lee, Yoo Jin ; Kim, You Na ; Park, Sungsoo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c441t-77d371bc05fcaed308235e6f5fae2313f680a79ca6e88d4d4a5668b813cf9cc03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Automotive parts</topic><topic>Diabetes</topic><topic>Gastrectomy</topic><topic>Gastric Fundus - surgery</topic><topic>Gastrointestinal surgery</topic><topic>Humans</topic><topic>Laparoscopy</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Obesity, Morbid - surgery</topic><topic>Original Contributions</topic><topic>Potassium</topic><topic>Stomach</topic><topic>Stomach - diagnostic imaging</topic><topic>Stomach - surgery</topic><topic>Surgeons</topic><topic>Surgery</topic><topic>Surgical Stapling</topic><topic>Sutures</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lee, Yoo Jin</creatorcontrib><creatorcontrib>Kim, You Na</creatorcontrib><creatorcontrib>Park, Sungsoo</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Obesity surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lee, Yoo Jin</au><au>Kim, You Na</au><au>Park, Sungsoo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Measurement of Stomach Wall Thickness to Guide Staple Selection during Sleeve Gastrectomy</atitle><jtitle>Obesity surgery</jtitle><stitle>OBES SURG</stitle><addtitle>Obes Surg</addtitle><date>2020-06-01</date><risdate>2020</risdate><volume>30</volume><issue>6</issue><spage>2140</spage><epage>2146</epage><pages>2140-2146</pages><issn>0960-8923</issn><eissn>1708-0428</eissn><abstract>Background
Sleeve gastrectomy has been considered a primary bariatric surgery; however, surgeons concerned with staple line leakage often query whether staples selected during stomach resection are of an appropriate size. This study aimed to measure gastric wall thickness using pathology laboratory measurements and to identify variables correlated with stomach wall thickness in patients who had undergone laparoscopic sleeve gastrectomy.
Methods
We obtained fresh resected stomach wall specimens from 30 patients. Stomach wall thickness was immediately measured postoperatively, comprising the muscle layer of the antrum, body, and fundus. Results were correlated with body mass index (BMI), age, and sex and with diagnoses of presurgical diabetes, hypertension, hyperlipidemia, and fatty liver.
Results
Stomach wall thickness ranged from 3.4 ± 4.3 mm to 1.0 ± 9.6 mm at the antrum. Except for the whole layer at the body wall, there was no significant correlation between wall thickness and other factors. At the body wall, whole layer wall thickness was found to positively correlate with age, sex, diabetes, and smoking (r = 0.469, − 0.391, 0.396, and 0.349, respectively;
p
< 0.05 in all patients).
Conclusion
Stomach wall thickness varied among patients who had undergone laparoscopic sleeve gastrectomy according to samples taken at three stomach wall sites. The range in wall thickness was normal, and thus, surgeons need not hesitate in selecting the staple height. Also, our study may be helpful to guide surgeon choice concerning the third or fourth staple around the body area when considering a patient’s independent factors.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>32062844</pmid><doi>10.1007/s11695-020-04439-x</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0001-7444-9490</orcidid></addata></record> |
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| ispartof | Obesity surgery, 2020-06, Vol.30 (6), p.2140-2146 |
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| subjects | Automotive parts Diabetes Gastrectomy Gastric Fundus - surgery Gastrointestinal surgery Humans Laparoscopy Medicine Medicine & Public Health Obesity, Morbid - surgery Original Contributions Potassium Stomach Stomach - diagnostic imaging Stomach - surgery Surgeons Surgery Surgical Stapling Sutures |
| title | Measurement of Stomach Wall Thickness to Guide Staple Selection during Sleeve Gastrectomy |
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