Evidence mapPaperPMID 30993513Full record

SynthesisSurgical endoscopy2020

Comparison of laparoscopic sleeve gastrectomy leak rates in five staple-line reinforcement options: a systematic review.

Michel Gagner, Paul Kemmeter

Open access · hybridAbstract readComparative StudySystematic Review
In one paragraph

Synthesis in Surgical endoscopy, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 52 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
52citing papers in PubMed, 4 pooled it
14.6field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

52 citing papers in PubMed, 4 syntheses or guidelines pooled it, 117 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Trial
  6. Article
  7. Article
  8. Article
  9. Article
  10. Article
  11. Towards a better mouse model of vertical sleeve gastrectomy.Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery · 2025
    Article
  12. Article
  13. Article
  14. Article
  15. BMJ open gastroenterology · 2024
    Article
  16. Article
  17. Article
  18. Article
  19. Review
  20. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

2 authors at 2 institutions in 2 countries.

Michel GagnerDepartment of Surgery, Hopital du Sacré Coeur, 315 Place D'Youville, Suite 191, Montréal, QC, H2Y 0A4, Canada. gagner.michel@gmail.com.ORCID 0000-0001-6068-0333
Paul KemmeterDepartment of Surgery, Mercy Health Saint Mary's, 2060 E Paris Ave SE #100, Grand Rapids, MI, USA.
Florida International University · USTrinity Health Grand Rapids · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundStaple-line leaks following laparoscopic sleeve gastrectomy (LSG) remain a concerning complication. Staple-line buttressing is largely adopted as an acceptable reinforcement but data regarding leaks have been equivocal. This study compared staple-line leaks in five reinforcement options during LSG: no reinforcement (NO-SLR), oversewing (suture), nonabsorbable bovine pericardial strips (BPS), tissue sealant or fibrin glue (Seal), or absorbable polymer membrane (APM).

methodsThis systematic review study of articles published between 2012 and 2016 regarding LSG leak rates aligned with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Variables of interest included leak rates, bleeding, and complications in addition to surgical and population parameters. An independent Fisher's exact test was used to compare the number of patients with and without leaks for the different reinforcement options.

resultsOf the 1633 articles identified, 148 met inclusion criteria and represented 40,653 patients. Differences in age (older in APM; p = 0.001), starting body mass index (lower in Suture; p = 0.008), and distance from pylorus (closer in BPS; p = 0.04) were observed between groups, but mean bougie size was equivalent. The overall leak rate of 1.5% (607 leaks) ranged from 0.7% for APM (significantly lower than all groups; p ≤ 0.007 for next lowest leak rate) to 2.7% (BPS).

conclusionsThis systematic review of staple-line leaks following LSG demonstrated a significantly lower rate using APM staple-line reinforcement as compared to oversewing, use of sealants, BPS reinforcement, or no reinforcement. Variation in surgical technique may also contribute to leak rates.

Indexed as

Anastomosis, SurgicalAnastomotic LeakGastrectomyHumansLaparoscopyOutcome Assessment, Health CareRisk FactorsSurgical StaplingBariatricLaparoscopic sleeve gastrectomyLeakLSGMetabolicReinforcementStaple lineSystematic review

Identifiers

PMID30993513
PMCPMC6946737
OpenAlexW2940338421

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.