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Gastric Wall Thickness and Linear Staple Height in Sleeve Gastrectomy in Japanese Patients with Obesity

Abstract

Background

Laparoscopic sleeve gastrectomy (LSG) is a standard procedure due to its low complication rates and favorable outcomes. However, limited data are available regarding the optimal size of linear staplers in relation to gastric wall thickness (GWT).

Methods

Between August 2016 and December 2020, we performed LSG in 70 patients with an average age, body weight, and body mass index of 42 years, 107 kg, and 40 kg/m2, respectively. We measured the GWT at the antrum, body, and fundus using resected specimens. We used an endo-linear stapler, and the closed staple height (CSH) was 1.75 mm.

Results

We found that the average GWT at the antrum was significantly thicker than the GWT at the body and fundus. There was a statistically significant relationship between body weight and the GWT at the antrum and body and obstructive sleep apnea and the GWT at the body. The average CSH/GWT ratios were 0.55, 0.62, and 0.90 at the antrum, body, and fundus, respectively. However, in 20 patients (29%), the CSH/GWT ratio at the fundus area was ≥ 1.0, and only preoperative body weight was a significant predictor for a CSH/GWT ratio of ≥ 1.0.

Conclusion

A light body weight may be related to a CSH/GWT ratio of ≥ 1.0 at the fundus.

Graphical abstract

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Fig. 1

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Correspondence to Yuichi Endo.

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Ethics Approval

All procedures performed in studies involving human participants complied 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. This study has been approved by the Ethics Committee of Oita University Hospital (# 1900).

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All participants included in the study provided written informed consent.

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The authors declare no competing interests.

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Key Points

GWT at the antrum was significantly thicker than that at the body and fundus.

GWT at the antrum and body statistically correlated with body weight.

Preoperative body weight was a predictor for the CSH/GWT ratio of ≥ 1.0 at the fundus

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Endo, Y., Ohta, M., Kawamura, M. et al. Gastric Wall Thickness and Linear Staple Height in Sleeve Gastrectomy in Japanese Patients with Obesity. OBES SURG 32, 349–354 (2022). https://doi.org/10.1007/s11695-021-05758-3

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  • DOI: https://doi.org/10.1007/s11695-021-05758-3

Keywords

  • Sleeve gastrectomy
  • Gastric wall thickness (GWT)
  • Closed staple height (CSH)
  • CSH/GWT