| Title: |
Inadvertent stapling of the orogastric tube during bariatric surgery ; Report of 3 cases and a systematic review |
| Authors: |
Çalikoğlu, İsmail; Özgen, Görkem; Yerdel, Mehmet Ali |
| Source: |
Medicine ; volume 100, issue 2, page e24144 ; ISSN 0025-7974 1536-5964 |
| Publisher Information: |
Ovid Technologies (Wolters Kluwer Health) |
| Publication Year: |
2021 |
| Description: |
Background: Entrapment of an orally introduced tube by stapling/stitching is an intra-operative complication of bariatric surgery with grave consequences. Incidence is unknown. No prevention/management strategy is available. A systematic review was performed to assess the absolute reported observed risk and incidence. Additionally, data on 3 cases during our entire sleeve gastrectomy (SG) experience is evaluated. Methods: Literature is reviewed using PubMed/Web of science data-bases. Data was recorded prospectively. Videos of orally introduced tube staplings were re-watched, presentation/recognition/management were re-evaluated. A protocol ensuring the removal of the small caliber orogastric tube (OGT) by the surgeons direct inspection was introduced after the 3rd entrapment. Results: Review revealed OGT as the most commonly entrapped tube following temperature probe and bougie. SG/stapling were the most common causative operation/reason, respectively. Leak rates over 20%, conversion, early-late re-operations and mortality were reported. During our 948 consecutive SGs, 3 OGT entrapments (0.32%), third one with double stapling, occurred. All were recognized/managed intraoperatively by freeing the entrapped-end of the OGT from the sleeve part of the staple-line. In doubly stapled case, second transected end could only be recognized when routine reinforcement suturing come in proximity. Defects were continuously stitched with barbed suture. No morbidity occurred. One-year excess-weight-loss was 82%. A pre-protocol incidence of 0.56% (n: 3/534) dropped to nil in the remaining 414. Conclusion: Iatrogenic stapling of the OGT during SG is rare, but morbid. It must be avoided by a strict protocol. Upon occurrence/recognition, stapling must immediately stop until the “entirety” of the tube, including the “specimen-part”, is retrieved, to avoid double entrapment. |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| DOI: |
10.1097/md.0000000000024144 |
| DOI: |
10.1097/MD.0000000000024144 |
| Availability: |
https://doi.org/10.1097/md.0000000000024144; https://journals.lww.com/10.1097/MD.0000000000024144 |
| Rights: |
http://creativecommons.org/licenses/by-nc-nd/4.0 |
| Accession Number: |
edsbas.4841FC59 |
| Database: |
BASE |