ISSN : 2146-3123
E-ISSN : 2146-3131

The Effects of Bougie Diameters on Tissue Oxygen Levels After Sleeve Gastrectomy: A Randomized Experimental Trial
Can Konca1, Ali Abbas Yılmaz2, Süleyman Utku Çelik1, Selami Ilgaz Kayılıoğlu3, Özge Tuğçe Paşaoğlu4, Halil Arda Ceylan5, Volkan Genç1
1Department of Surgery, Ankara University School of Medicine, Ankara, Turkey
2Department of Anesthesiology and Reanimation, Ankara University School of Medicine, Ankara, Turkey
3Department of Surgery, Numune Training and Research Hospital, Ankara, Turkey
4Department of Medical Biochemistry, Gazi University Faculty of Medicine, Ankara, Turkey
5Department of Internal Medicine, Ankara University School of Medicine, Ankara, Turkey
DOI : 10.4274/balkanmedj.2017.0484

Background: Staple-line leak is the most frightening complication of laparoscopic sleeve gastrectomy and several predisposing factors such as using improper staple sizes regardless of gastric wall thickness, narrower bougie diameter and ischemia of the staple line are asserted.
Aims: The goal of this study was to evaluate the effects of different bougie diameters on tissue oxygen partial pressure at the esophagogastric junction after sleeve gastrectomy.
Study Design: The study was designed as a randomized and controlled animal experiment with 1:1:1:1 allocation ratio.
Methods: Thirty-two male Wistar Albino rats were randomly divided into 4 groups of 8 each. While 12 Fr bougies were used in groups 1 and 3, 8 Fr bougies were used in groups 2 and 4. Fibrin sealant application was also carried out around the gastrectomy line after sleeve gastrectomy in groups 3 and 4. Burst pressure of gastrectomy line, tissue oxygen partial pressure (PtO2) and hydroxyproline levels at the esophagogastric junction were measured and compared among groups.
Results: Mortality was detected in 2 out of 32 rats (6.25%) and one of them was in group 2 and the cause of this mortality was gastric leak. Gastric leak was detected in 2 out of 32 rats (6.25%). There was no significant difference in terms of burst pressures, PtO2 and tissue hydroxyproline levels among the 4 groups.
Conclusions: We conclude that the use of narrower bougie sizes and fibrin sealant do not have any effect on tissue perfusion and wound healing after sleeve gastrectomy.

Keywords : Bariatric surgery, gastrectomy, gastric mucosa, hypoxia, ischemia

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