Endoscopic Treatment of Staple-Line Leaks After Sleeve Gastrectomy in Patients with Obesity: Which One is the Best Option, if Any? A Systematic Review with Meta-Analysis and Meta-regression.

IF 3.1 3区医学 Q1 SURGERY

Obesity Surgery Pub Date : 2025-10-20 DOI:10.1007/s11695-025-08294-6

Giuseppe Galloro, Mariano Cesare Giglio, Alessia Chini, Rosa Maione, Matteo Pollastro, Rosa Vitale, Antonio Pisani, Mario Musella

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Abstract

Laparoscopic sleeve gastrectomy (LSG) is the most common bariatric surgery, with staple-line leak (SLL) as its most severe complication. Various endoscopic treatments exist, but no universal algorithm is established. The aim of this paper is to estimate the success rates of different endoscopic techniques for SLL management. A search of Medline, Embase, and SCOPUS identified studies on endoscopic treatments. Pooled success rates were calculated using random-effects modeling. Seventy-nine studies (2205 patients) showed an overall success rate of 84.1%. Double-pigtail drainage (90.07%), endoscopic vacuum therapy (90.2%), and septotomy (88.25%) were most effective. Meta-regression indicated significantly higher success with double-pigtail drainage (p = 0.035). Endoscopic treatments, especially double-pigtail drainage and vacuum therapy, are highly effective for SLL. Further research is needed to compare techniques and evaluate additional clinical factors.

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内镜治疗肥胖患者袖式胃切除术后钉线泄漏：如果有的话，哪一种是最好的选择？meta分析与meta回归的系统回顾。

腹腔镜袖式胃切除术（LSG）是最常见的减肥手术，其最严重的并发症是钉线漏（SLL）。有各种内镜治疗方法，但没有建立通用的算法。本文的目的是估计不同内窥镜技术治疗SLL的成功率。在Medline， Embase和SCOPUS中搜索发现了关于内窥镜治疗的研究。使用随机效应模型计算合并成功率。79项研究（2205例）显示总成功率为84.1%。双尾引流（90.07%）、内镜下真空治疗（90.2%）和鼻中隔切开术（88.25%）效果最好。meta回归显示双尾纤引流成功率显著提高（p = 0.035）。内镜治疗，特别是双尾引流和真空治疗是治疗SLL非常有效的方法。需要进一步的研究来比较技术和评估其他临床因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Obesity Surgery 医学-外科

CiteScore

5.80

自引率

24.10%

发文量

567

审稿时长

3-6 weeks

期刊介绍： Obesity Surgery is the official journal of the International Federation for the Surgery of Obesity and metabolic disorders (IFSO). A journal for bariatric/metabolic surgeons, Obesity Surgery provides an international, interdisciplinary forum for communicating the latest research, surgical and laparoscopic techniques, for treatment of massive obesity and metabolic disorders. Topics covered include original research, clinical reports, current status, guidelines, historical notes, invited commentaries, letters to the editor, medicolegal issues, meeting abstracts, modern surgery/technical innovations, new concepts, reviews, scholarly presentations and opinions. Obesity Surgery benefits surgeons performing obesity/metabolic surgery, general surgeons and surgical residents, endoscopists, anesthetists, support staff, nurses, dietitians, psychiatrists, psychologists, plastic surgeons, internists including endocrinologists and diabetologists, nutritional scientists, and those dealing with eating disorders.