Comparison of stricture rates using three different gastrojejunostomy anastomotic techniques in laparoscopic Roux-en-Y gastric bypass

Azam Qureshi, Dina Podolsky, Lindsay Cumella, Mujahid Abbas, Jenny Choi, Pratibha Vemulapalli, Diego Camacho

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Introduction: No single gastrojejunostomy anastomosis technique (GJA) in Laparoscopic Roux-en-Y gastric bypass (LRYGB) is currently preferred over another. Bendewald et al. confirmed that there was no difference in anastomotic stricture rates when comparing hand-sewn (HS), linear-stapled (LS), and circular-stapled (CS) GJA techniques. We present and analyze our own institutional data to readdress stricture rates. Methods: From January 2010 to January 2013, 860 consecutive patients underwent LRYGB using HS, LS, and CS anastomotic techniques at a single institution. All patients in this study were followed to see if they had a complication of a stricture within this time period. Hospital records were retrospectively reviewed and those who had stricture complications shown on endoscopy requiring intervention were compiled and compared using univariate analysis. Results: Patient demographics did not differ substantially between the three groups. The most common technique employed was LS (n = 429, 49.8 %), followed by CS (n = 254, 29.5 %) and HS (n = 177, 20.6 %), respectively. Using multivariate analysis, there was a significant difference in the rate of strictures between the anastomotic techniques (LS 4.42 %, HS 2.82 %, CS 1.18 %, p = 0.0163). Conclusions: Our data show that the discussion of which anastomotic technique is superior should be reopened given the statistically significant low rate of strictures in patients who underwent LRYGB with a CS anastomosis in comparison with LS and HS anastomoses.

Original languageEnglish (US)
Pages (from-to)1737-1740
Number of pages4
JournalSurgical Endoscopy and Other Interventional Techniques
Volume29
Issue number7
DOIs
StatePublished - Jul 19 2015

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Gastric Bypass
Pathologic Constriction
Hand
Hospital Records
Endoscopy
Multivariate Analysis
Demography

Keywords

  • Bariatric surgery
  • Laparoscopic roux-en-y gastric bypass
  • Stricture rates

ASJC Scopus subject areas

  • Surgery

Cite this

Comparison of stricture rates using three different gastrojejunostomy anastomotic techniques in laparoscopic Roux-en-Y gastric bypass. / Qureshi, Azam; Podolsky, Dina; Cumella, Lindsay; Abbas, Mujahid; Choi, Jenny; Vemulapalli, Pratibha; Camacho, Diego.

In: Surgical Endoscopy and Other Interventional Techniques, Vol. 29, No. 7, 19.07.2015, p. 1737-1740.

Research output: Contribution to journalArticle

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abstract = "Introduction: No single gastrojejunostomy anastomosis technique (GJA) in Laparoscopic Roux-en-Y gastric bypass (LRYGB) is currently preferred over another. Bendewald et al. confirmed that there was no difference in anastomotic stricture rates when comparing hand-sewn (HS), linear-stapled (LS), and circular-stapled (CS) GJA techniques. We present and analyze our own institutional data to readdress stricture rates. Methods: From January 2010 to January 2013, 860 consecutive patients underwent LRYGB using HS, LS, and CS anastomotic techniques at a single institution. All patients in this study were followed to see if they had a complication of a stricture within this time period. Hospital records were retrospectively reviewed and those who had stricture complications shown on endoscopy requiring intervention were compiled and compared using univariate analysis. Results: Patient demographics did not differ substantially between the three groups. The most common technique employed was LS (n = 429, 49.8 {\%}), followed by CS (n = 254, 29.5 {\%}) and HS (n = 177, 20.6 {\%}), respectively. Using multivariate analysis, there was a significant difference in the rate of strictures between the anastomotic techniques (LS 4.42 {\%}, HS 2.82 {\%}, CS 1.18 {\%}, p = 0.0163). Conclusions: Our data show that the discussion of which anastomotic technique is superior should be reopened given the statistically significant low rate of strictures in patients who underwent LRYGB with a CS anastomosis in comparison with LS and HS anastomoses.",
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AU - Qureshi, Azam

AU - Podolsky, Dina

AU - Cumella, Lindsay

AU - Abbas, Mujahid

AU - Choi, Jenny

AU - Vemulapalli, Pratibha

AU - Camacho, Diego

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N2 - Introduction: No single gastrojejunostomy anastomosis technique (GJA) in Laparoscopic Roux-en-Y gastric bypass (LRYGB) is currently preferred over another. Bendewald et al. confirmed that there was no difference in anastomotic stricture rates when comparing hand-sewn (HS), linear-stapled (LS), and circular-stapled (CS) GJA techniques. We present and analyze our own institutional data to readdress stricture rates. Methods: From January 2010 to January 2013, 860 consecutive patients underwent LRYGB using HS, LS, and CS anastomotic techniques at a single institution. All patients in this study were followed to see if they had a complication of a stricture within this time period. Hospital records were retrospectively reviewed and those who had stricture complications shown on endoscopy requiring intervention were compiled and compared using univariate analysis. Results: Patient demographics did not differ substantially between the three groups. The most common technique employed was LS (n = 429, 49.8 %), followed by CS (n = 254, 29.5 %) and HS (n = 177, 20.6 %), respectively. Using multivariate analysis, there was a significant difference in the rate of strictures between the anastomotic techniques (LS 4.42 %, HS 2.82 %, CS 1.18 %, p = 0.0163). Conclusions: Our data show that the discussion of which anastomotic technique is superior should be reopened given the statistically significant low rate of strictures in patients who underwent LRYGB with a CS anastomosis in comparison with LS and HS anastomoses.

AB - Introduction: No single gastrojejunostomy anastomosis technique (GJA) in Laparoscopic Roux-en-Y gastric bypass (LRYGB) is currently preferred over another. Bendewald et al. confirmed that there was no difference in anastomotic stricture rates when comparing hand-sewn (HS), linear-stapled (LS), and circular-stapled (CS) GJA techniques. We present and analyze our own institutional data to readdress stricture rates. Methods: From January 2010 to January 2013, 860 consecutive patients underwent LRYGB using HS, LS, and CS anastomotic techniques at a single institution. All patients in this study were followed to see if they had a complication of a stricture within this time period. Hospital records were retrospectively reviewed and those who had stricture complications shown on endoscopy requiring intervention were compiled and compared using univariate analysis. Results: Patient demographics did not differ substantially between the three groups. The most common technique employed was LS (n = 429, 49.8 %), followed by CS (n = 254, 29.5 %) and HS (n = 177, 20.6 %), respectively. Using multivariate analysis, there was a significant difference in the rate of strictures between the anastomotic techniques (LS 4.42 %, HS 2.82 %, CS 1.18 %, p = 0.0163). Conclusions: Our data show that the discussion of which anastomotic technique is superior should be reopened given the statistically significant low rate of strictures in patients who underwent LRYGB with a CS anastomosis in comparison with LS and HS anastomoses.

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