TITLE:
Circular versus Linear versus Hand-Sewn Gastrojejunostomy in Roux-en-Y-Gastric Bypass: Data Analysis from a Quality Assurance Study of the Surgical Treatment of Obesity in Germany
AUTHORS:
Christine Stroh, Grigorji Nesterov, Rudolf Weiner, Frank Benedix, Christian Knoll, Matthias Pross, Thomas Manger
KEYWORDS:
Roux-en-Y-Gastric Bypass, Circular versus Linear versus Hand-Sewn Anastomosis, Complications
JOURNAL NAME:
Surgical Science,
Vol.5 No.7,
July
8,
2014
ABSTRACT: Background: Since January
12005, the outcomes of bariatric surgeries have been recorded in Germany. All
data are registered prospectively in cooperation with the Institute of Quality
Assurance in Surgery at Otto-von-Guericke University Magdeburg.Methods: Data are collected in an
online data bank. Data collection began in 2005 for the results of Roux-en-Y
Gastric Bypass (RYGB). In addition to primary bariatric operations, data
regarding the complications and the amelioration of comorbidities have been
analyzed. Participation in the quality assurance study is required for all
certified centers in Germany.Results: Roux-en-Y Gastric Bypass is
the most popular bariatric operation in Germany. There were 5115 operations
performed from 2005 to 2010. A circular anastomosis was performed in 1587
patients, and a linear anastomosis was performed in 2734 patients. In 783
patients the hand-sewn technique was used. The leakage rate for the linear technique
is 1.6%, and the leakage rate is 1.2% for circular anastomosis and 1.4% for
hand-sewn technique. The overall postoperative complication rate was
significantly higher using the circular technique than using the linear or
hand-sewn approach.Conclusion: RYGB is a popular
procedure in Germany. The complication rate has decreased since 2005. A
comparison of hand sewn versus linear and versus circular anastomosis indicated
a higher complication rate in circular gastrojejunal junctions.