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Barbed vs conventional sutures in bariatric surgery: a propensity score analysis from a high-volume center

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Abstract

The use of barbed sutures for constructing an anastomosis is favoured by a few bariatric surgeons as compared to conventional sutures. The aim of this study is to assess safety and efficacy of barbed sutures to close the gastric pouch–jejunal anastomosis (GPJA) in laparoscopic gastric bypass (Roux-en-Y gastric bypass—RYGB, and One-Anastomosis gastric bypass—OAGB) using propensity score-matching (PSM) analysis. A retrospective analysis of patients who underwent primary laparoscopic gastric bypasses between January 2012 and December 2017 was performed. Patients were divided into two different groups (RYGB-G and OAGB-G). PSM analysis was performed to minimize patient selection bias between the two types of sutures (barbed—BS and conventional—CS) in each group. A total of 808 patients were reviewed. After PSM, 488 (244 BS vs 244 CS) patients in RYGB-G and 48 in OAGB-G (24 BS vs 24 CS) patients were compared. Median operative time was significantly shorter (p < 0.001) for BS in RYGB-G. In OAGB-G, BS were associated with a shorter operative time, although no significant difference was observed (p = 0.183). Post-operative hospital stay was significantly shorter for BS in both the groups (p < 0.001). Post-operative 30th-day complications were comparable: no leakage or bleeding of GPJA was observed in BS groups. At median follow-up of 28.78 months, no late complications were observed. Barbed sutures appear to be effective to close GPJA during gastric bypass and as safe as conventional suture. Further studies are necessary to draw definitive conclusions.

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Authors and Affiliations

  1. U.O.C. Chirurgia Endocrina e Metabolica, Fondazione Policlinico Universitario A. Gemelli IRCCS, L.go A. Gemelli 8, 00168, Rome, Italy

    Francesco Pennestrì, Pierpaolo Gallucci, Francesca Prioli, Piero Giustacchini, Luigi Ciccoritti, Luca Sessa, Rocco Bellantone & Marco Raffaelli

  2. Università Cattolica del Sacro Cuore, Rome, Italy

    Pierpaolo Gallucci, Francesca Prioli, Rocco Bellantone & Marco Raffaelli

Authors
  1. Francesco Pennestrì
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  2. Pierpaolo Gallucci
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  3. Francesca Prioli
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  4. Piero Giustacchini
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  5. Luigi Ciccoritti
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  6. Luca Sessa
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  7. Rocco Bellantone
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  8. Marco Raffaelli
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Contributions

Study conception and design: FP and LS. Acquisition of data: PG and FP. Analysis and interpretation of data: PG and LC. Drafting of manuscript: FP and LS. Critical revision of manuscript: RB and MR

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Correspondence to Luca Sessa.

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Pennestrì, F., Gallucci, P., Prioli, F. et al. Barbed vs conventional sutures in bariatric surgery: a propensity score analysis from a high-volume center. Updates Surg 71, 113–120 (2019). https://doi.org/10.1007/s13304-018-0589-2

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  • DOI: https://doi.org/10.1007/s13304-018-0589-2

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