Editorial
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Jul 25, 2015; 7(9): 843-846
Published online Jul 25, 2015. doi: 10.4253/wjge.v7.i9.843
Staple-line leak after sleve gastrectomy in obese patients: A hot topic in bariatric surgery
Giuseppe Galloro, Simona Ruggiero, Teresa Russo, Donato Alessandro Telesca, Mario Musella, Marco Milone, Raffaele Manta
Giuseppe Galloro, Simona Ruggiero, Teresa Russo, Donato Alessandro Telesca, Department of Clinical Medicine and Surgery, Surgical Digestive Endoscopy Unit, University Federico II - School of Medicine, 80131 Naples, Italy
Mario Musella, Marco Milone, Department of Advanced Biomedical Sciences, General Surgery Unit, University Federico II - School of Medicine, 80131 Naples, Italy
Raffaele Manta, Digestive Endoscopy Unit, Niguarda Hospital, 20162 Milan, Italy
Author contributions: Galloro G designed research, drafted the artile and gave final approval; Ruggiero S, Russo T and Telesca DA analyzed data; Musella M and Milone M made critical revision; Manta R drafted the artile, made critical revision.
Conflict-of-interest statement: No conflict of interest is related to this article. No conflict of interest to declare for any author.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Giuseppe Galloro, MD, Professor, Department of Clinical Medicine and Surgery, Surgical Digestive Endoscopy Unit, University Federico II - School of Medicine, Via S. Pansini, 5, 80131 Naples, Italy. giuseppe.galloro@unina.it
Telephone: +39-81-7462046 Fax: +39-81-7462815
Received: April 22, 2015
Peer-review started: April 30, 2015
First decision: May 13, 2015
Revised: June 8, 2015
Accepted: June 18, 2015
Article in press: June 19, 2015
Published online: July 25, 2015
Processing time: 103 Days and 18.3 Hours
Abstract

Laparoscopic sleeve gastrectomy is a surgical procedure that is being increasingly performed on obese patients. Among its complications, leaks are the most serious and life threatening. The placement of esophageal, covered, self-expandable metal stents in these cases has been performed by many authors but reports on the outcome of this procedure are limited and the technical aspects are not well defined. Stent migration is the main complication of the procedure and poses a challenge to the surgeon, with a limited number of options. Here we evaluate the technical and clinical outcome of a new, dedicated, self-expanding metal stent, comparing the advantages of this stent to those traditionally used to treat staple-line leak after sleeve gastrectomy. While published data are limited, they seem support the use of this kind of new stent as the best option for the stenting treatment of a staple-line leak after sleeve gastrectomy, over other kinds of stents. Further studies based on larger series are needed to better evaluate patient outcome.

Keywords: Bariatric surgery; Leak; Obesity; Sleeve gastrectomy; Endoscopic stent; Therapy

Core tip: Laparoscopic sleeve gastrectomy (LSG) is a surgical procedure increasingly performed on obese patients with convincing outcomes. Among its complications, leaks are the most serious. The use of esophageal self-expandable metal stents in these cases has been performed by many authors but reports are limited and stent migration is the main complication of the procedure. Megastent®, a new stent dedicated to the treatment of leaks after LSG, seems to resolve most of the problems of the esophageal stents. While published data are limited, they seem support the use of Megastent® as the best option for the stenting treatment of a staple-line leak after sleeve gastrectomy. Further studies on larger series are needed to better evaluate definitive outcomes.