Outcomes of a novel bariatric stent in the management of sleeve gastrectomy leaks: a multicenter study

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art_MOURA_Outcomes_of_a_novel_bariatric_stent_in_the_2019.PDF (1.91 MB)
Citações na Scopus
21
Tipo de produção
article
Data de publicação
2019
DOI
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
ELSEVIER SCIENCE INC
Autores
NETO, Manoel Galvao
JIRAPINYO, Pichamol
TEIXEIRA, Newton
ORSO, Ivan
QUADROS, Luiz Gustavo
AMORIM, Artagnan
MEDEIROS, Filipe
NETO, Durval Rosa
Citação
SURGERY FOR OBESITY AND RELATED DISEASES, v.15, n.8, p.1241-1251, 2019
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Background: The management of laparoscopic sleeve gastrectomy leaks remains a challenge. This can be treated with placement of self-expandable metal stents, which are most effective in the acute and early settings. However, migration is a frequent adverse event (AE). Novel, fully covered stents with a larger proximal flare to limit migration designed specifically to treat postsleeve leaks were recently introduced. Objectives: The aim of this study was to evaluate the safety and efficacy of a novel stent specifically designed for postsleeve leaks treatment. Setting: Multicenter retrospective study. Methods: This is a multicenter study, including patients with acute and early post laparoscopic sleeve gastrectomy leaks, treated with a large bariatric stent. The outcomes include technical success, clinical success, and safety profile. A multivariable regression was performed to assess predictors of success. Results: Thirty-seven patients were included (10 acute and 27 early leaks), with 30 stents in the postpyloric (POST) and 7 in the prepyloric position. Technical success was 100%. Mean stent dwell time was 29.08 days. Clinical success was achieved in 78.37%. Leak duration, leak size, and stent dwell time did not correlate with clinical success. During follow-up, 8 patients had stent migration (21.62%) and all were in a POST position. AE poststent removal were also evaluated (prepyloric: 57.14% vs POST: 33.3%, P = .45). There was no difference between prepyloric and POST position in the severe AE analysis. Conclusions: This novel, large-caliber, fully covered stent specifically designed for sleeve leaks appears to be effective at treating acute and early leaks. However, the large flanges and long stent length do not appear to reduce migration rate and may be associated with higher overall severe AE rates. Avoiding placement in the POST position may help mitigate migration risk; however, owing to the risk profile this stent should be used with caution.
Palavras-chave
Bariatric surgery, Obesity, Sleeve, Endoscopy, Endoscopic treatment, Leak, Fistula, Stent
URI
https://observatorio.fm.usp.br/handle/OPI/34148
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Coleções
Artigos e Materiais de Revistas Científicas - HC/ICHC
Artigos e Materiais de Revistas Científicas - LIM/35
Artigos e Materiais de Revistas Científicas - ODS/03