Influence of staple line reinforcement on the occurrence of bleeding complications following laparoscopic sleeve gastrectomy: a retrospective analysis

Introduction

Laparoscopic sleeve gastrectomy (LSG) has gained prominence as a therapeutic option for obesity and metabolic diseases. The choice of staple line reinforcement technique in LSG remains a subject of debate, particularly concerning postoperative bleeding complications.

Aim

The aim of this retrospective analysis is to assess the influence of different staple line reinforcement techniques on the occurrence of bleeding complications LSG.

Material and methods

We conducted a retrospective analysis of patients undergoing LSG between September 2021 and April 2023 at our institution. Patients were stratified into two groups based on the staple line reinforcement method: continuous suturing (n = 53) and clipping (n = 28). Surgical outcomes, including operative time, length of hospital stay, and bleeding complications, were assessed. Complications were classified using the Clavien-Dindo classification.

Results

Continuous suturing was associated with a significantly longer operative time (88.15 min vs. 74.64 min, p < 0.05) but a similar length of hospital stay. Notably, no bleeding complications occurred in the continuous suturing group, while the clipping group experienced postoperative bleeding in 7.14% of cases (p < 0.05). Continuous suturing exhibited a slightly higher incidence of minor complications classified as Class I in the Clavien-Dindo classification (7.55% vs. 0%).

Conclusions

This retrospective analysis suggests that continuous suturing may provide enhanced hemostasis along the staple line, reducing the risk of postoperative bleeding compared to clipping. Despite the longer operative time and a slightly higher rate of minor complications, the clinical significance of these findings should be considered within the context of individual patient risk profiles.

The influence of obesity on the safety of laparoscopic cholecystectomy: a retrospective analysis

Introduction

The increasing prevalence of obesity worldwide has raised concerns about its impact on surgical outcomes across various procedures. Laparoscopic cholecystectomy (LC), a common surgical intervention for benign gallbladder disease, is no exception. The relationship between obesity and LC outcomes remains complex and merits further investigation.

Aim

This retrospective study aimed to assess the influence of obesity on the safety and surgical outcomes of LC.

Material and methods

Patients were divided into 2 groups: those with obesity (body mass index (BMI) ≥ 30 kg/m²) and non-obese controls (BMI < 30 kg/m²). Baseline characteristics, operative duration, hospitalization length, and post-operative complications, categorized by the Clavien-Dindo classification, were evaluated.

Results

Among 116 patients with obesity and 176 non-obese controls, differences in age and gender were noted but were not clinically significant. Operative time was longer in the group with obesity. Hospitalization length and adverse event occurrence did not differ significantly. Importantly, post-operative complications showed no substantial differences between the groups, suggesting that obesity may not significantly increase the complication risk in this population.

Conclusions

Obesity may not substantially elevate the risk of adverse events or severe complications following LC in this patient population. Careful patient selection, preoperative evaluation, and surgical technique remain crucial. Further research in larger, diverse populations is needed to validate these findings.

Effects of obesity on outcomes of laparoscopic transabdominal preperitoneal inguinal hernia repair: a retrospective analysis

INTRODUCTION

Inguinal hernia repair, particularly the transabdominal preperitoneal (TAPP) technique, is common worldwide. Obesity (body mass index [BMI] ≥30 kg/m2) can influence surgical outcomes, potentially resulting in longer operative time, higher complication rate, and prolonged hospital stay.

AIM

This study aimed to evaluate the impact of obesity on surgical outcomes following laparoscopic TAPP inguinal hernia repair.

MATERIALS AND METHODS

We retrospectively reviewed data from patients who underwent laparoscopic TAPP inguinal hernia repair between September 2021 and December 2023. We included patients aged 18 years or older who had elective unilateral TAPP repair for primary inguinal hernia. The patients were categorized based their BMI as obese (BMI ≥30 kg/m2) and nonobese (BMI <⁠30 kg/m2). Outcomes assessed included recurrence rate, surgical site infections (SSIs), operative time, and length of hospital stay.

RESULTS

We analyzed 201 patients of whom 30 (14.8%) were obese and 171 (85.2%) were nonobese. Recurrence rates were 6.67% in the obese and 2.35% in the nonobese patients (P = 0.222). No SSIs were observed in the obese patients, as compared with 1.76% in the nonobese individuals (P = 1). Mean (SD) operative time was 78.87 (31.88) minutes for the obese and 70.28 (27.25) minutes for the nonobese patients (P = 0.203). Mean (SD) hospital stay was 3.13 (0.35) days for the patients with and 3.05 (0.28) days for those without obesity (P = 0.086).

CONCLUSIONS

There were no significant differences in recurrence rates, SSIs, operative time, or hospital stay between the obese and nonobese patients. Appropriate surgical expertise and perioperative management can result in comparable outcomes for both groups. Further research is recommended to understand the impact of obesity on hernia recurrence.

Outcomes of laparoscopic transabdominal preperitoneal hernia repair in the elderly population: a retrospective cohort study

INTRODUCTION

Hernia repair is a common procedure, especially among the elderly. In the face of rising life expectancy, adequate hernia management in older adults is crucial. Laparoscopic transabdominal preperitoneal patch plasty (TAPP) for hernia repair is minimally invasive, but poses challenges in the elderly due to a larger number of comorbidities.

AIM

The aim of this study was to evaluate the safety and efficacy of TAPP hernia repair in patients aged 70 years and older.

MATERIALS AND METHODS

Our retrospective study reviewed data of patients who underwent elective unilateral TAPP repair for primary inguinal hernia between September 2021 and December 2023. The patients were divided by age: 70 and older (cases) and younger than 70 (controls). Primary outcomes included recurrence rate, surgical site infections (SSIs), operative time, and hospital stay. Data were analyzed with descriptive statistics and inferential tests.

RESULTS

The study included 201 patients (47 cases and 154 controls). The mean (SD) age was 75.74 (4.73) years for the cases and 53.47 (12.8) years for the controls. No recurrences were found in the elderly (cases) group, while the control group recorded a 3.92% recurrence rate (P = 0.34). SSIs affected 2.13% of the cases and 1.31% of the controls (P = 0.55). Operative times were similar (71.44 vs 71.96 min; P = 0.8). Hospital stay was 3.11 days for the cases and 3.04 days for the controls (P = 0.14).

CONCLUSIONS

Laparoscopic TAPP hernia repair is a safe and effective procedure in the elderly and its outcomes are comparable to those recorded in younger patients. Further studies are needed to validate these results.