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.
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Acknowledgments
We would like to express our wholehearted gratitude to all participating patients.
Funding
This research was supported by a grant of Korea University Anam Hospital, Seoul, Repulic of Korea (Grant No. O1904911).
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
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Lee, Y.J., Kim, Y.N. & Park, S. Measurement of Stomach Wall Thickness to Guide Staple Selection during Sleeve Gastrectomy. OBES SURG 30, 2140–2146 (2020). https://doi.org/10.1007/s11695-020-04439-x
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DOI: https://doi.org/10.1007/s11695-020-04439-x