Abstract：
BACKGROUND: Sleeve gastrectomy (SG) is currently the most frequently performed procedure for obesity worldwide. Staple line reinforcement (SLR) has been suggested as a strategy to reduce the risk of staple line leak or bleeding; however, its use for SG in the United Kingdom (UK) is unknown. This study examined the effect of SLR on the development of postoperative complications from SG using a large national dataset from the UK.
METHODS: Patients undergoing either primary or revision SG over 10 years from Jan 2012 to Dec 2021 were identified by the National Bariatric Surgery Registry. Comparative and logistic regression analyses were undertaken to determine the effect of SLR on staple line leak and bleeding.
RESULTS: During this time, 14,231 patients underwent SG for whom there were complete data. Of these, 76.5% were female and the median age was 46 years (IQR: 36-53). The rate of surgical complications was 2.3% (n = 219/14,231). The incidence of bleeding was 1.3% (n = 179/14,231) and leak was 1.0% (n = 140/14,231). Over time, the use of SLR of any variety declined significantly from 99.7% in 2012 to 57.3% in 2021 (p < 0.001). Multivariable (adjusted) regression analysis demonstrated that neither the use of nor the type of reinforcement had any effect on the rate of bleeding or leaking.
CONCLUSIONS: SLR for SG has declined in the UK since 2012. There were no differences in staple line leak or bleed with or without reinforcement.
METHODS: Patients undergoing either primary or revision SG over 10 years from Jan 2012 to Dec 2021 were identified by the National Bariatric Surgery Registry. Comparative and logistic regression analyses were undertaken to determine the effect of SLR on staple line leak and bleeding.
RESULTS: During this time, 14,231 patients underwent SG for whom there were complete data. Of these, 76.5% were female and the median age was 46 years (IQR: 36-53). The rate of surgical complications was 2.3% (n = 219/14,231). The incidence of bleeding was 1.3% (n = 179/14,231) and leak was 1.0% (n = 140/14,231). Over time, the use of SLR of any variety declined significantly from 99.7% in 2012 to 57.3% in 2021 (p < 0.001). Multivariable (adjusted) regression analysis demonstrated that neither the use of nor the type of reinforcement had any effect on the rate of bleeding or leaking.
CONCLUSIONS: SLR for SG has declined in the UK since 2012. There were no differences in staple line leak or bleed with or without reinforcement.
摘要：
背景：袖状胃切除术（SG）是目前世界上最常见的肥胖手术。已建议将缝线加固（SLR）作为降低缝线渗漏或出血风险的策略；但是，在英国（UK）用于SG的用途未知。这项研究使用英国的大型国家数据集检查了SLR对SG术后并发症发展的影响。
方法：国家减重外科注册中心确定了从2012年1月至2021年12月10年以上接受初次或修正SG的患者。进行了比较和逻辑回归分析，以确定SLR对缝合线渗漏和出血的影响。
结果：在此期间，14,231例接受SG的患者有完整的数据。其中,76.5％为女性，中位年龄为46岁（IQR：36-53）。手术并发症发生率为2.3％（n=219/14,231）。出血发生率为1.3%（n=179/14,231），渗漏发生率为1.0%（n=140/14,231）。随着时间的推移,任何品种单反的使用率从2012年的99.7%显著下降到2021年的57.3%(p<0.001)。多变量（调整后的）回归分析表明，钢筋的使用或类型对出血或渗漏率都没有任何影响。
结论：自2012年以来，英国SG的SLR有所下降。在有或没有加固的情况下，钉线泄漏或出血没有差异。
方法：国家减重外科注册中心确定了从2012年1月至2021年12月10年以上接受初次或修正SG的患者。进行了比较和逻辑回归分析，以确定SLR对缝合线渗漏和出血的影响。
结果：在此期间，14,231例接受SG的患者有完整的数据。其中,76.5％为女性，中位年龄为46岁（IQR：36-53）。手术并发症发生率为2.3％（n=219/14,231）。出血发生率为1.3%（n=179/14,231），渗漏发生率为1.0%（n=140/14,231）。随着时间的推移,任何品种单反的使用率从2012年的99.7%显著下降到2021年的57.3%(p<0.001)。多变量（调整后的）回归分析表明，钢筋的使用或类型对出血或渗漏率都没有任何影响。
结论：自2012年以来，英国SG的SLR有所下降。在有或没有加固的情况下，钉线泄漏或出血没有差异。
