Journal of Laparoendoscopic & Advanced Surgical Techniques最新文献

{"title":"Innovative Approaches to Managing Postoperative Complications in Laparoscopic Sleeve Gastrectomy: A Scoping Review.","authors":"Ntiak Achi, Huanhuan Wang, Jinjin Hao, Wenliang Chen","doi":"10.1089/lap.2024.0227","DOIUrl":"10.1089/lap.2024.0227","url":null,"abstract":"<p><p><b><i>Background:</i></b> Laparoscopic sleeve gastrectomy (LSG) is an effective surgical intervention for obesity, but managing complications post LSG remains crucial. Given the global prevalence of obesity, innovative approaches are needed to improve patient outcomes. <b><i>Objective:</i></b> This scoping review aimed to comprehensively map the existing literature on innovative approaches for managing complications in adult patients undergoing LSG to treat morbid obesity. This management strategy may include surgical techniques, perioperative care, nutritional support, or other relevant strategies. <b><i>Methods:</i></b> A systematic search of PubMed and Scopus databases was conducted to identify relevant studies. The prespecified inclusion criteria were applied through a two-stage screening process. Studies involving adult patients who underwent LSG for morbid obesity (body mass index > 35) and those investigating interventions related to complications were included. The scoping review process adhered to Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. The results were summarized using a narrative approach. <b><i>Results:</i></b> This review included 31 studies with 4547 participants, showing diverse study designs, patient demographics, and surgical locations. Among them, 6 were case reports, 18 were randomized controlled trials, and 7 were retrospective studies. Complications of LSG include staple-line leaks, stenosis, hemorrhage, infection, gastric volvulus, and nutrient malabsorption. Innovative interventions, such as staple-line reinforcement, plication methods, and the Over-the-Scope Clip system, have been investigated for effective management. <b><i>Conclusion:</i></b> This scoping review provides valuable insights into innovative interventions for managing complications post LSG. This review highlights the need for further research to explore long-term outcomes, compare different interventions, and address the existing gaps in the literature.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":"6-14"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142591747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Effectiveness of Different Cystic Duct Ligation Techniques in Laparoscopic Cholecystectomy: A Systematic Review and Network Meta-Analysis.","authors":"Christos Athanasiou, Ahmed Radwan, Saeed Qureshi, Aditya Kanwar, Vasilis Kosmoliaptsis, Somaiah Aroori","doi":"10.1089/lap.2024.0295","DOIUrl":"10.1089/lap.2024.0295","url":null,"abstract":"<p><p><b><i>Background:</i></b> Laparoscopic cholecystectomy is one of the most common surgical procedures. Several techniques of ligating the cystic duct have been compared in randomized trials, but data on comparative effectiveness are missing. Our aim was to systematically review the literature and, if appropriate, synthesize the available evidence. <b><i>Methods:</i></b> A systematic search of PubMed, Scopus, Ovid, and Cochrane Library was conducted to identify randomized studies comparing different ligation techniques of the cystic duct in laparoscopic cholecystectomy. Network meta-analysis synthesized evidence from all available techniques. Techniques compared were metal (MC), absorbable (AC), or polymer clips (PC), suture ligation (SL), and ultrasonic shears (US). <b><i>Results:</i></b> Twenty-three randomized studies with 2851 patients were included in our study. A well-connected network was formed for bile leak and a star-shaped network for operative time, with MC as the common comparator. No difference was found when SL, AC, US, or PC were compared for bile leak. Operative time was statistically significantly reduced when US were compared to MC (mean difference [MD] = -14.32 [-19.37, -9.28]), SL MD = -20.16 (-10.84, -29.47), and AC MD = -18.32 (-1.25, -35.39). The remaining techniques had similar operative times. PC had the highest probability of being the best technique <i>P</i> = 41.8, and SL had the highest probability <i>P</i> = 46.1 of being the second best for bile leak. US had a 98.1% chance of being the best technique for operative time. <b><i>Conclusions:</i></b> Given that all techniques demonstrate similar efficacy, the decision should be based on cost, familiarity with the technique, and environmental factors.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":"31-35"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142741279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acknowledgment of Reviewers 2024.","authors":"","doi":"10.1089/lap.2024.12309.revack","DOIUrl":"https://doi.org/10.1089/lap.2024.12309.revack","url":null,"abstract":"","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":"35 1","pages":"101"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation and Analysis of the Clinical Effects of Laparoscopic Surgery for Pediatric Direct Inguinal Hernia.","authors":"Tao Chengpin, Cao Yongsheng, Mao Changkun","doi":"10.1089/lap.2024.0158","DOIUrl":"10.1089/lap.2024.0158","url":null,"abstract":"<p><p><b><i>Objective:</i></b> To assess both the clinical effectiveness and practical experience of utilizing laparoscopic methods for addressing direct inguinal hernia in the pediatric population. <b><i>Method:</i></b> The study collected clinical data from 10 pediatric patients with direct inguinal hernia treated at the Children's Hospital of Anhui Province from July 2014 to July 2023. Among them, there were 8 males and 2 females, with an average age of 43.4 ± 22.0 months. All were initially diagnosed with indirect inguinal hernia before surgery. During the laparoscopic procedures, direct hernia was confirmed. Two cases had undergone open hernial sac high ligation surgery due to misdiagnosis as indirect hernia, resulting in recurrent groin bulges postoperatively. For these cases, laparoscopic direct hernia neck ligation with reinforcement and repair using the inner side of the umbilical ligament was performed. <b><i>Results:</i></b> All 10 cases of pediatric patients underwent surgeries smoothly without any need for open conversion. The average surgical duration was 29.8 ± 15.0 minutes, with minimal intraoperative bleeding. Patients were discharged on the first day postoperatively, and no significant surgery-related complications were observed. During the 12-month follow-up period, it was noted that the scar at the umbilical ring was superficial and inconspicuous. There were no occurrences of hernia recurrence, testicular retraction, or atrophy. <b><i>Conclusion:</i></b> Laparoscopic treatment for pediatric direct inguinal hernia has demonstrated favorable therapeutic outcomes, ensuring a safe surgical process, rapid recovery, and a low postoperative recurrence rate. The laparoscopic approach, specifically utilizing direct hernia neck ligation with reinforcement and repair using the inner side of the umbilical ligament, proves to be a secure and effective treatment for pediatric direct inguinal hernia. It can be considered as a conventional treatment method.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":"89-93"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142584708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is Sarcopenia Associated with Worse Outcomes Following Ventral Hernia Repair? A Systematic Review and Meta-Analysis.","authors":"Carlos A Balthazar da Silveira, Diego B S Zamata-Ovalle, Ana Caroline D Rasador, João P G Kasakewitch, Flavio Malcher, Diego L Lima","doi":"10.1089/lap.2024.0319","DOIUrl":"10.1089/lap.2024.0319","url":null,"abstract":"<p><p><b><i>Background:</i></b> The concept of preoperative prehabilitation has garnered attention as a means to manage the comorbidities of patients undergoing ventral hernia repair (VHR). In this regard, some comorbidities have been studied as potential risk factors for postoperative complications following VHR, such as diabetes, immunosuppression, and smoking. However, evidence regarding the impact of sarcopenia, defined by reduced muscle mass and highly associated with frailty syndrome, remains a gap. We aimed to perform a systematic review and meta-analysis analyzing the impact of sarcopenia on VHR outcomes. <b><i>Methods:</i></b> Cochrane Central, Embase, PubMed, MEDLINE, and Web of Science were searched for studies analyzing the impact of sarcopenia on VHR from inception until April 2024. Outcomes assessed were recurrence, surgical site occurrences (SSO), surgical site infection (SSI), and hospital length of stay (LOS). Data analysis was done using RStudio 4.1.2 Software. <b><i>Results:</i></b> The initial search yielded 263 results, of which 172 were screened after the exclusion of the duplicates. The full-text review was done for eight studies, of which three were included after applying the eligibility criteria. Our sample comprised 275 patients, of which 79 (28,7%) presented with sarcopenia. All included studies used radiological muscle findings to define sarcopenia. Our analysis showed no differences in recurrence rates between patients with sarcopenia and controls (risk ratios [RR]: 1.24; 95% confidence interval [CI]: 0.79-1.94; <i>P</i> = .35). Furthermore, no differences were found in SSI (RR: 0.7; 95% CI: 0.39-1.25.; <i>P</i> = .23). Interestingly, a higher SSO rate was noted for patients without sarcopenia (95% CI: 0.35-0.96; <i>P</i> = .04). No differences were found in LOS (mean difference 4.7 hours; 95% CI: -0.67 to 10.1; <i>P</i> = .4). <b><i>Conclusion:</i></b> Our analysis showed no differences were found in recurrence, SSI, and LOS following VHR in patients with sarcopenia. Furthermore, there was a reduced SSO for patients with sarcopenia.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":"42-47"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142796432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Individualized Treatment of Multiple Magnetic Foreign Body Ingestion in Children.","authors":"Yi Chen, Qingjiang Chen, Yunzhong Qian, Linyan Wang, Sai Chen, Shuhao Zhang, Zhigang Gao","doi":"10.1089/lap.2024.0059","DOIUrl":"10.1089/lap.2024.0059","url":null,"abstract":"<p><p><b><i>Background:</i></b> The incidence of multiple magnetic foreign body (MMFB) ingestion in children is rising, which poses a serious risk for gastrointestinal tract injury. In the current study, the clinical characteristics were analyzed to enhance awareness among parents and caregivers, treatment experiences were summarized and discussed, and optimal treatment plans were identified. <b><i>Methods:</i></b> A retrospective analysis was performed on 130 pediatric patients with MMFB ingestion at the Children's Hospital Affiliated with Zhejiang University School of Medicine, between June 2016 and June 2023. The clinical data, treatment details, and patient prognosis were systematically collected. <b><i>Results:</i></b> Forty-one patients were managed conservatively, while 89 patients underwent open surgery. Among the 44 patients who were treated with laparoscopic surgery, conversion to laparotomy was necessary in 28. The risk of gastrointestinal perforation was higher in symptomatic children than in asymptomatic children (chi-square value: 37.156; <i>P</i> < .001). Perforations were mainly observed in the small intestine. The median length of hospital stay was 10 days in the cohort of 16 children who underwent laparoscopic surgery successfully, which differed from the group of 28 children who were converted to a laparotomy (10 days [interquartile range, or IQR: 9-12.75 days] versus 12 days [IQR: 10-15.75 days]; <i>P</i> < .05). <b><i>Conclusions:</i></b> The ingestion of MMFBs in children can lead to severe injuries, underscoring the importance of early detection and treatment. Tailored clinical management strategies should be implemented based on individual conditions, while prompt and effective interventions can minimize harm. Therefore, we propose a comprehensive framework for individualized treatment processes.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":"94-100"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Enhanced-View Totally Extraperitoneal Repair for Ventral and Incisional Hernia: Midterm Results of an Evolving Technique.","authors":"Andrea Sanna, Simone Targa, Barbara Mantovan, Maurizio De Luca","doi":"10.1089/lap.2023.0354","DOIUrl":"10.1089/lap.2023.0354","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> In the field of abdominal wall hernias, several innovative procedures have been developed, including the extended/enhanced-view totally extraperitoneal (eTEP) hernia repair technique. Initially introduced for laparoscopic hernia repair by J. Daes, it was subsequently applied to ventral hernia repair (VHR) and incisional hernia repair (IVHR) by I. Belyansky et al. This article presents the midterm experience and outcomes of our center's experience with the endoscopic technique based on the principles of eTEP during IVHR and VHR. <b><i>Method:</i></b> A review was conducted of a prospectively collected database of abdominal wall hernia. Patients who underwent eTEP VHR or IVHR between October 2018 and February 2021 were identified. <b><i>Results:</i></b> A total of 51 patients underwent an eTEP-RS or eTEP-TAR procedure, with a 24-month follow-up period. Of the 51 patients included in the study, 43 underwent eTEP-RS treatment, while 8 required an additional transversus abdominis release (3 unilaterally). One patient developed a large hematoma necessitating reoperation and drainage via the eTEP approach. Seven patients developed seromas, which were treated conservatively, while 2 patients experienced surgical site infections, which were managed with a single-use negative pressure wound therapy system. Two patients exhibited recurrence at sites above the epigastric edge of the mesh. <b><i>Conclusion:</i></b> Moreover, the advancement of minimally invasive surgical techniques for abdominal wall reconstruction has rendered the eTEP approach a viable option for both primary and incisional VHR, with promising midterm outcomes.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":"48-54"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142796437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Total Transanal Endorectal Pull-through Versus Laparoscopic-Assisted Approach in Children with Rectosigmoid Hirschsprung's Disease: A Systematic Review and Meta-Analysis.","authors":"Kexin Wang, Chuanping Xie, Jiayu Yan, Yajun Chen","doi":"10.1089/lap.2023.0448","DOIUrl":"10.1089/lap.2023.0448","url":null,"abstract":"<p><p><b><i>Objective:</i></b> To compare the clinical outcomes between total transanal endorectal pull-through (TTEPT) and laparoscopic-assisted transanal endorectal pull-through (LTEPT) in children with rectosigmoid Hirschsprung's disease. <b><i>Methods:</i></b> A retrospective study was conducted to compare patients with rectosigmoid Hirschsprung's disease who underwent TTEPT or LTEPT at Beijing Children's Hospital between January 2016 and June 2021. Clinical details were collected from medical records. Patients' parents completed the Krickenbeck questionnaire to evaluate the long-term bowel function (age >4 years) by telephone. A literature search was conducted by using the National Center for Biotechnology Information (NCBI) PubMed database. We combined data from our data with eligible articles and performed a meta-analysis. <b><i>Result:</i></b> From our data, there was no difference in the incidence of postoperative complications or long-term bowel function between the patients undergoing TTEPT and LTEPT. A meta-analysis, including five published articles and our data, was performed with a total of 414 patients (<i>n</i> = 236 with TTEPT and <i>n</i> = 178 with LTEPT). For postoperative complications, there were no significant differences between TTEPT and LTEPT for the incidence of HAEC (odds ratio [OR], 0.90; 95% confidence interval [CI], 0.45-1.80; <i>P</i> = .77) or anastomotic leak (OR, 2.52; 95% CI, 0.40-15.80; <i>P</i> = .32). Regarding bowel function outcomes, the incidence of soiling (OR, 1.77; 95% CI, 0.84-3.71; <i>P</i> = .13) and constipation (OR, 1.20; 95% CI, 0.54-2.64; <i>P</i> = .66) were also similar for the two approaches. <b><i>Conclusion:</i></b> There was no significant difference in postoperative complications and bowel functional outcomes in patients with rectosigmoid HD undergoing TTEPT or LTEPT. <b><i>Levels of Evidence:</i></b> III.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":"80-88"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140900142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Short-Term Efficacy of Transumbilical Single-Incision Versus Conventional Laparoscopic Cholecystectomy: A Retrospective Cohort Study.","authors":"Fuguo Liu, Ran Cui, Muladili Mutailipu, Zinan Zhao, Xujing Wang, Bo Chen, Yongkun Wang","doi":"10.1089/lap.2024.0325","DOIUrl":"10.1089/lap.2024.0325","url":null,"abstract":"<p><p><b><i>Background:</i></b> With the rising demand for minimally invasive and cosmetically appealing surgeries, transumbilical single-incision laparoscopic cholecystectomy (SILC) has been increasingly adopted, albeit in a limited number of medical centers. Our team has successfully executed transumbilical SILC for benign gallbladder diseases. This study retrospectively analyzed and compared the efficacy of transumbilical SILC with that of conventional laparoscopic cholecystectomy (CLC). <b><i>Methods:</i></b> We analyzed data from 358 cases of laparoscopic cholecystectomy performed at Shanghai East Hospital of Tongji University between January 2021 and October 2023. Of these, 186 cases underwent SILC (observation group), while 172 cases underwent CLC (control group). We compared patient demographics, perioperative outcomes, and satisfaction with incision scars. Primary outcomes included surgical efficacy and safety, whereas secondary outcomes encompassed postoperative hospitalization duration, pain levels, hospital costs, and scar satisfaction. <b><i>Results:</i></b> No significant differences were observed in patient demographics between the two groups. Both the SILC and CLC groups exhibited similar operative times (39.56 ± 14.55 minutes versus 41.82 ± 16.13 minutes, <i>P</i> = .164) and intraoperative blood loss (11.34 ± 3.90 mL versus 11.28 ± 3.87 mL, <i>P</i> = .885). The single-incision approach led to earlier postoperative bowel function recovery (22.03 ± 3.60 hours versus 24.17 ± 3.22 hours, <i>P</i> < .01), lower 24-hour postoperative pain scores (2.06 ± 0.84 versus 2.35 ± 0.72, <i>P</i> < .01), shorter postoperative hospital stays (2.88 ± 0.86 days versus 3.33 ± 0.96 days, <i>P</i> < .01), comparable hospitalization costs (3411.67 ± 790.86$ versus 3494.50 ± 558.76$, <i>P</i> = .257), and better Scar Cosmesis Assessment and Rating scores (1.78 ± 0.70 versus 2.17 ± 0.89, <i>P</i> < .01). Patient satisfaction was higher with the single-incision technique (8.52 ± 0.79 versus 7.80 ± 0.75, <i>P</i> < .01). Both groups experienced one case of incision infection (SILC 0.54%, CLC 0.58%), and there was one case of postoperative bile leakage in the CLC group (0.58%). However, the difference in complications was not statistically significant (<i>P</i> > .05). <b><i>Conclusion:</i></b> Transumbilical SILC demonstrates safe and effective near-term efficacy, offering benefits such as reduced postoperative pain and improved cosmetic outcomes, which support its clinical adoption.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":"36-41"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do Abdominoplasties in Patients with Prior Sleeve Gastrectomy Impact De Novo Gastroesophageal Reflux Disorder and the Need for Conversion to Roux-en-Y Gastric Bypass?","authors":"Robin Berk, Diego L Lima, Michelle Park, Joaquin Serra, Cristian Echeverri, Rebeca Dominguez-Profeta, Matthew Wynn, Diego Camacho","doi":"10.1089/lap.2024.0313","DOIUrl":"10.1089/lap.2024.0313","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> The sleeve gastrectomy (SG) often requires conversion to Roux-en-Y gastric bypass (RYGB) due to gastroesophageal reflux disorder (GERD). Many postbariatric patients seek body-contouring surgery such as abdominoplasty to remove unwanted skin and fat. Although the number of abdominoplasties performed in postbariatric patients is increasing each year, the number of conversion surgeries is increasing in accordance. This study evaluates the impact of abdominoplasties in patients with prior SG on the development of GERD and the need for conversion to RYGB. <b><i>Methods:</i></b> A retrospective study was conducted with 630 patients who underwent conversions from SG to RYGB at our institution between January 2014 and December 2023. Outcomes were stratified for comparison between patients with GERD as an indication for conversion and patients with inadequate weight loss as an indication for conversion. Between the two groups we compared the number of patients with post-SG abdominoplasty and the number of hiatal hernias (HH) seen during conversion surgery. A logistic regression analysis was performed to identify factors independently associated with GERD. <b><i>Results:</i></b> There was a statistically significant higher number of abdominoplasties in patients who underwent conversion to RYGB for GERD (29 patients, 8.6%) compared to inadequate weight loss (12 patients, 4.1%), <i>P</i> value .034. However, these patients also had statistically significantly more HH (98 patients, 28.9%) compared to patients with inadequate weight loss as an indication for conversion (46 patients, 15.8%), <i>P</i> value <.001. In the logistic regression comparing these two variables, only the presence of HH seen during surgery was found to be a significant predictor of GERD (odds ratio 2.7, confidence interval 1.7-4.1, <i>P</i> < .001). <b><i>Conclusion:</i></b> Our data shows that abdominoplasty surgery does not directly influence the development of GERD in post-SG patients. However, the presence of HH in this population significantly impacts the development of GERD, often necessitating conversion to RYGB.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":"1094-1098"},"PeriodicalIF":1.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}