Linear or circular: Anastomotic ulcer after gastric bypass surgery
Background After laparoscopic Gastric Bypass Procedure (GBP), anastomotic ulcers (AU) at the gastrojejunostomy (GJ) occur in up to 16% of the patients. Surgical techniques seem to influence the development of AU, but this is still a matter of discussion. This study aims to compare the incidence of A...
Gespeichert in:
| Veröffentlicht in: | Surgical endoscopy 2022-05, Vol.36 (5), p.3011-3018 |
|---|---|
| Hauptverfasser: | , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 3018 |
|---|---|
| container_issue | 5 |
| container_start_page | 3011 |
| container_title | Surgical endoscopy |
| container_volume | 36 |
| creator | Schäfer, Aline Gehwolf, Philipp Kienzl-Wagner, Katrin Cakar-Beck, Fergül Wykypiel, Heinz |
| description | Background
After laparoscopic Gastric Bypass Procedure (GBP), anastomotic ulcers (AU) at the gastrojejunostomy (GJ) occur in up to 16% of the patients. Surgical techniques seem to influence the development of AU, but this is still a matter of discussion. This study aims to compare the incidence of AU in circular-stapled (CS) versus linear-stapled (LS) gastrojejunostomy.
Methods
Single-centre retrospective analysis of 241 (m 77 /f 164) consecutive patients (126 CS, 115 LS) with primary or revisional GBP including Roux-Y-Gastric Bypass (RYGB) and One-Anastomosis Gastric Bypass (OAGB) between 01/2014 and 01/2018. Follow-up with oesophagogastroduodenoscopy was only performed in symptomatic patients. Age, body mass index (BMI), comorbidities, smoking and medication were analyzed in both groups. The data are reported as total numbers (%) and mean ± standard deviation.
Results
AU occurred significantly more often in the CS group than in the LS group (
p
= 0.0034). Moreover, refractory AU and the need for revisional surgery were higher in the CS group. Smoking correlates significantly with the development of AU, whereas other risk factors had no impact on its incidence.
Conclusion
Linear-stapled gastrojejunostomy with a long and narrow pouch should be the preferable procedure for reducing AU development risk. Smoking cessation minimizes the risk for AU and is a necessary part of the treatment. |
| doi_str_mv | 10.1007/s00464-021-08597-6 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_9001202</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2649148723</sourcerecordid><originalsourceid>FETCH-LOGICAL-c404t-6973c66169ecc78cc548a7960528ae57b05eee385db27ba8feaac5175ea26283</originalsourceid><addsrcrecordid>eNp9kclKBDEQhoMoOi4v4EEavHhprexpD8IobjDgxXtIx5qxpaczJt3CvL3RcT94qUDVV3-l6idkn8IxBdAnCUAoUQKjJRhZ6VKtkREVnJWMUbNORlBxKJmuxBbZTukJMl9RuUm2uKCSCalG5HzSdOhiEWLhm-iH1sXTYty51Id56BtfDK3HWLhpn-Msp2PO1cuFS6lIQ5xhXO6SjalrE-59vDvk_ury_uKmnNxd316MJ6UXIPpSVZp7paiq0HttvJfCOF0pkMw4lLoGiYjcyIea6dqZKTrnJdUSHVPM8B1ytpJdDPUcHzx2fXStXcRm7uLSBtfY35WuebSz8GIrAMqAZYGjD4EYngdMvZ03yWPbug7DkCyTgmsQWqiMHv5Bn8IQu7ydZSrfUBjNeKbYivIxpBRx-vUZCvbNIbtyyGaH7LtD9k364OcaXy2flmSAr4CUS10-8Pfsf2RfAeXwnFY</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2649148723</pqid></control><display><type>article</type><title>Linear or circular: Anastomotic ulcer after gastric bypass surgery</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Schäfer, Aline ; Gehwolf, Philipp ; Kienzl-Wagner, Katrin ; Cakar-Beck, Fergül ; Wykypiel, Heinz</creator><creatorcontrib>Schäfer, Aline ; Gehwolf, Philipp ; Kienzl-Wagner, Katrin ; Cakar-Beck, Fergül ; Wykypiel, Heinz</creatorcontrib><description>Background
After laparoscopic Gastric Bypass Procedure (GBP), anastomotic ulcers (AU) at the gastrojejunostomy (GJ) occur in up to 16% of the patients. Surgical techniques seem to influence the development of AU, but this is still a matter of discussion. This study aims to compare the incidence of AU in circular-stapled (CS) versus linear-stapled (LS) gastrojejunostomy.
Methods
Single-centre retrospective analysis of 241 (m 77 /f 164) consecutive patients (126 CS, 115 LS) with primary or revisional GBP including Roux-Y-Gastric Bypass (RYGB) and One-Anastomosis Gastric Bypass (OAGB) between 01/2014 and 01/2018. Follow-up with oesophagogastroduodenoscopy was only performed in symptomatic patients. Age, body mass index (BMI), comorbidities, smoking and medication were analyzed in both groups. The data are reported as total numbers (%) and mean ± standard deviation.
Results
AU occurred significantly more often in the CS group than in the LS group (
p
= 0.0034). Moreover, refractory AU and the need for revisional surgery were higher in the CS group. Smoking correlates significantly with the development of AU, whereas other risk factors had no impact on its incidence.
Conclusion
Linear-stapled gastrojejunostomy with a long and narrow pouch should be the preferable procedure for reducing AU development risk. Smoking cessation minimizes the risk for AU and is a necessary part of the treatment.</description><identifier>ISSN: 0930-2794</identifier><identifier>EISSN: 1432-2218</identifier><identifier>DOI: 10.1007/s00464-021-08597-6</identifier><identifier>PMID: 34152456</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Abdominal Surgery ; Body mass index ; Endoscopy ; Gastric Bypass - adverse effects ; Gastric Bypass - methods ; Gastroenterology ; Gastrointestinal surgery ; Gynecology ; Heart surgery ; Hepatology ; Humans ; Infections ; Laparoscopy ; Laparoscopy - methods ; Medicine ; Medicine & Public Health ; Metabolism ; Nonsteroidal anti-inflammatory drugs ; Obesity, Morbid - surgery ; Ostomy ; Proctology ; Retrospective Studies ; Smoking cessation ; Standard deviation ; Surgery ; Surgical techniques ; Sutures ; Thoracic surgery ; Treatment Outcome ; Ulcer - etiology ; Ulcer - surgery ; Ulcers</subject><ispartof>Surgical endoscopy, 2022-05, Vol.36 (5), p.3011-3018</ispartof><rights>The Author(s) 2021</rights><rights>2021. The Author(s).</rights><rights>The Author(s) 2021. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c404t-6973c66169ecc78cc548a7960528ae57b05eee385db27ba8feaac5175ea26283</citedby><cites>FETCH-LOGICAL-c404t-6973c66169ecc78cc548a7960528ae57b05eee385db27ba8feaac5175ea26283</cites><orcidid>0000-0002-1761-555X</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/s00464-021-08597-6$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00464-021-08597-6$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,780,784,885,27922,27923,41486,42555,51317</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34152456$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Schäfer, Aline</creatorcontrib><creatorcontrib>Gehwolf, Philipp</creatorcontrib><creatorcontrib>Kienzl-Wagner, Katrin</creatorcontrib><creatorcontrib>Cakar-Beck, Fergül</creatorcontrib><creatorcontrib>Wykypiel, Heinz</creatorcontrib><title>Linear or circular: Anastomotic ulcer after gastric bypass surgery</title><title>Surgical endoscopy</title><addtitle>Surg Endosc</addtitle><addtitle>Surg Endosc</addtitle><description>Background
After laparoscopic Gastric Bypass Procedure (GBP), anastomotic ulcers (AU) at the gastrojejunostomy (GJ) occur in up to 16% of the patients. Surgical techniques seem to influence the development of AU, but this is still a matter of discussion. This study aims to compare the incidence of AU in circular-stapled (CS) versus linear-stapled (LS) gastrojejunostomy.
Methods
Single-centre retrospective analysis of 241 (m 77 /f 164) consecutive patients (126 CS, 115 LS) with primary or revisional GBP including Roux-Y-Gastric Bypass (RYGB) and One-Anastomosis Gastric Bypass (OAGB) between 01/2014 and 01/2018. Follow-up with oesophagogastroduodenoscopy was only performed in symptomatic patients. Age, body mass index (BMI), comorbidities, smoking and medication were analyzed in both groups. The data are reported as total numbers (%) and mean ± standard deviation.
Results
AU occurred significantly more often in the CS group than in the LS group (
p
= 0.0034). Moreover, refractory AU and the need for revisional surgery were higher in the CS group. Smoking correlates significantly with the development of AU, whereas other risk factors had no impact on its incidence.
Conclusion
Linear-stapled gastrojejunostomy with a long and narrow pouch should be the preferable procedure for reducing AU development risk. Smoking cessation minimizes the risk for AU and is a necessary part of the treatment.</description><subject>Abdominal Surgery</subject><subject>Body mass index</subject><subject>Endoscopy</subject><subject>Gastric Bypass - adverse effects</subject><subject>Gastric Bypass - methods</subject><subject>Gastroenterology</subject><subject>Gastrointestinal surgery</subject><subject>Gynecology</subject><subject>Heart surgery</subject><subject>Hepatology</subject><subject>Humans</subject><subject>Infections</subject><subject>Laparoscopy</subject><subject>Laparoscopy - methods</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Metabolism</subject><subject>Nonsteroidal anti-inflammatory drugs</subject><subject>Obesity, Morbid - surgery</subject><subject>Ostomy</subject><subject>Proctology</subject><subject>Retrospective Studies</subject><subject>Smoking cessation</subject><subject>Standard deviation</subject><subject>Surgery</subject><subject>Surgical techniques</subject><subject>Sutures</subject><subject>Thoracic surgery</subject><subject>Treatment Outcome</subject><subject>Ulcer - etiology</subject><subject>Ulcer - surgery</subject><subject>Ulcers</subject><issn>0930-2794</issn><issn>1432-2218</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9kclKBDEQhoMoOi4v4EEavHhprexpD8IobjDgxXtIx5qxpaczJt3CvL3RcT94qUDVV3-l6idkn8IxBdAnCUAoUQKjJRhZ6VKtkREVnJWMUbNORlBxKJmuxBbZTukJMl9RuUm2uKCSCalG5HzSdOhiEWLhm-iH1sXTYty51Id56BtfDK3HWLhpn-Msp2PO1cuFS6lIQ5xhXO6SjalrE-59vDvk_ury_uKmnNxd316MJ6UXIPpSVZp7paiq0HttvJfCOF0pkMw4lLoGiYjcyIea6dqZKTrnJdUSHVPM8B1ytpJdDPUcHzx2fXStXcRm7uLSBtfY35WuebSz8GIrAMqAZYGjD4EYngdMvZ03yWPbug7DkCyTgmsQWqiMHv5Bn8IQu7ydZSrfUBjNeKbYivIxpBRx-vUZCvbNIbtyyGaH7LtD9k364OcaXy2flmSAr4CUS10-8Pfsf2RfAeXwnFY</recordid><startdate>20220501</startdate><enddate>20220501</enddate><creator>Schäfer, Aline</creator><creator>Gehwolf, Philipp</creator><creator>Kienzl-Wagner, Katrin</creator><creator>Cakar-Beck, Fergül</creator><creator>Wykypiel, Heinz</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>C6C</scope><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>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</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>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-1761-555X</orcidid></search><sort><creationdate>20220501</creationdate><title>Linear or circular: Anastomotic ulcer after gastric bypass surgery</title><author>Schäfer, Aline ; Gehwolf, Philipp ; Kienzl-Wagner, Katrin ; Cakar-Beck, Fergül ; Wykypiel, Heinz</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c404t-6973c66169ecc78cc548a7960528ae57b05eee385db27ba8feaac5175ea26283</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Abdominal Surgery</topic><topic>Body mass index</topic><topic>Endoscopy</topic><topic>Gastric Bypass - adverse effects</topic><topic>Gastric Bypass - methods</topic><topic>Gastroenterology</topic><topic>Gastrointestinal surgery</topic><topic>Gynecology</topic><topic>Heart surgery</topic><topic>Hepatology</topic><topic>Humans</topic><topic>Infections</topic><topic>Laparoscopy</topic><topic>Laparoscopy - methods</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Metabolism</topic><topic>Nonsteroidal anti-inflammatory drugs</topic><topic>Obesity, Morbid - surgery</topic><topic>Ostomy</topic><topic>Proctology</topic><topic>Retrospective Studies</topic><topic>Smoking cessation</topic><topic>Standard deviation</topic><topic>Surgery</topic><topic>Surgical techniques</topic><topic>Sutures</topic><topic>Thoracic surgery</topic><topic>Treatment Outcome</topic><topic>Ulcer - etiology</topic><topic>Ulcer - surgery</topic><topic>Ulcers</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Schäfer, Aline</creatorcontrib><creatorcontrib>Gehwolf, Philipp</creatorcontrib><creatorcontrib>Kienzl-Wagner, Katrin</creatorcontrib><creatorcontrib>Cakar-Beck, Fergül</creatorcontrib><creatorcontrib>Wykypiel, Heinz</creatorcontrib><collection>Springer Nature OA Free Journals</collection><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>Nursing & Allied Health Database</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>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>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</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><collection>PubMed Central (Full Participant titles)</collection><jtitle>Surgical endoscopy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Schäfer, Aline</au><au>Gehwolf, Philipp</au><au>Kienzl-Wagner, Katrin</au><au>Cakar-Beck, Fergül</au><au>Wykypiel, Heinz</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Linear or circular: Anastomotic ulcer after gastric bypass surgery</atitle><jtitle>Surgical endoscopy</jtitle><stitle>Surg Endosc</stitle><addtitle>Surg Endosc</addtitle><date>2022-05-01</date><risdate>2022</risdate><volume>36</volume><issue>5</issue><spage>3011</spage><epage>3018</epage><pages>3011-3018</pages><issn>0930-2794</issn><eissn>1432-2218</eissn><abstract>Background
After laparoscopic Gastric Bypass Procedure (GBP), anastomotic ulcers (AU) at the gastrojejunostomy (GJ) occur in up to 16% of the patients. Surgical techniques seem to influence the development of AU, but this is still a matter of discussion. This study aims to compare the incidence of AU in circular-stapled (CS) versus linear-stapled (LS) gastrojejunostomy.
Methods
Single-centre retrospective analysis of 241 (m 77 /f 164) consecutive patients (126 CS, 115 LS) with primary or revisional GBP including Roux-Y-Gastric Bypass (RYGB) and One-Anastomosis Gastric Bypass (OAGB) between 01/2014 and 01/2018. Follow-up with oesophagogastroduodenoscopy was only performed in symptomatic patients. Age, body mass index (BMI), comorbidities, smoking and medication were analyzed in both groups. The data are reported as total numbers (%) and mean ± standard deviation.
Results
AU occurred significantly more often in the CS group than in the LS group (
p
= 0.0034). Moreover, refractory AU and the need for revisional surgery were higher in the CS group. Smoking correlates significantly with the development of AU, whereas other risk factors had no impact on its incidence.
Conclusion
Linear-stapled gastrojejunostomy with a long and narrow pouch should be the preferable procedure for reducing AU development risk. Smoking cessation minimizes the risk for AU and is a necessary part of the treatment.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>34152456</pmid><doi>10.1007/s00464-021-08597-6</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-1761-555X</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0930-2794 |
| ispartof | Surgical endoscopy, 2022-05, Vol.36 (5), p.3011-3018 |
| issn | 0930-2794 1432-2218 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_9001202 |
| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Abdominal Surgery Body mass index Endoscopy Gastric Bypass - adverse effects Gastric Bypass - methods Gastroenterology Gastrointestinal surgery Gynecology Heart surgery Hepatology Humans Infections Laparoscopy Laparoscopy - methods Medicine Medicine & Public Health Metabolism Nonsteroidal anti-inflammatory drugs Obesity, Morbid - surgery Ostomy Proctology Retrospective Studies Smoking cessation Standard deviation Surgery Surgical techniques Sutures Thoracic surgery Treatment Outcome Ulcer - etiology Ulcer - surgery Ulcers |
| title | Linear or circular: Anastomotic ulcer after gastric bypass surgery |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-14T14%3A06%3A14IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Linear%20or%20circular:%20Anastomotic%20ulcer%20after%20gastric%20bypass%20surgery&rft.jtitle=Surgical%20endoscopy&rft.au=Sch%C3%A4fer,%20Aline&rft.date=2022-05-01&rft.volume=36&rft.issue=5&rft.spage=3011&rft.epage=3018&rft.pages=3011-3018&rft.issn=0930-2794&rft.eissn=1432-2218&rft_id=info:doi/10.1007/s00464-021-08597-6&rft_dat=%3Cproquest_pubme%3E2649148723%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2649148723&rft_id=info:pmid/34152456&rfr_iscdi=true |