The Effects of Bougie Diameters on Tissue Oxygen Levels After Sleeve Gastrectomy: A Randomized Experimental Trial

Abstract

Background: Staple-line leak is the most frightening complication oflaparoscopic sleeve gastrectomy and several predisposing factors suchas using improper staple sizes regardless of gastric wall thickness,narrower bougie diameter and ischemia of the staple line are asserted.Aims: To evaluate the effects of different bougie diameters on tissueoxygen partial pressure at the esophagogastric junction after sleevegastrectomy.Study Design: A randomized and controlled animal experiment with1:1:1:1 allocation ratio.Methods: Thirty-two male Wistar Albino rats were randomly dividedinto 4 groups of 8 each. While 12-Fr bougies were used in groups1 and 3, 8-Fr bougies were used in groups 2 and 4. Fibrin sealantapplication was also carried out around the gastrectomy line aftersleeve gastrectomy in groups 3 and 4. Burst pressure of gastrectomyline, tissue oxygen partial pressure and hydroxyproline levels atthe esophagogastric junction were measured and compared amonggroups.Results: Mortality was detected in 2 out of 32 rats (6.25%) and one ofthem 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 nosignificant difference in terms of burst pressures, tissue oxygen partialpressure and tissue hydroxyproline levels among the 4 groups.Conclusion: The use of narrower bougie along with fibrin sealant hasnot had a negative effect on tissue perfusion and wound healing.