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Introduction: To achieve effective weight loss and remission of comorbidities, various surgical methods are used in the treatment of obesity. The most common procedures performed worldwide are followed by the newest ones. Aim: To present the results of the first group of patients from a high-volume bariatric centre in central Europe and to compare single anastomosis sleeve ileal (SASI) as a primary and revisional procedure. Material and methods: We retrospectively analysed patients who underwent SASI for obesity from December 2018 to June 2022 by the same team of surgeons. There were 2 groups of patients. The first group consisted of patients who underwent SASI as their first bariatric procedure (primary group - PG). The second group consisted of patients who underwent SASI after previous SG procedure due to weight regain and/or symptoms of gastroesophageal reflux disease (GERD) (revisional group - RG). Results: There were 15 patients (80% female) in the PG, and 14 patients (88% female) in the RG. In the PG, %TWL 12 and 36 months after surgery was 37.8% and 43.9% respectively. In the RG, %TWL 12 and 24 months after surgery was 13.8% and 20.9%, respectively. Most patients had complete remission of T2D and HT after surgery. In the RG, 9 (81.8%) patients had remission of GERD. The worsening of GERD was reported in 4 (40%) patients in the PG. Conclusions: SASI may be an effective and safe method of treatment of obesity. SASI may be an effective method of revisional bariatric surgery performed for GERD, but not for weight regain.
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PURPOSE: Laparoscopic sleeve gastrectomy (LSG) is currently the most common bariatric surgery in the world. Although it appears to be a safe treatment for obesity, it is still at risk of complications. The latest literature shows that postoperative bleeding occurs in 2-4% of cases, and up to 3% of cases requires reoperation for hemostasis. The aim of the study is to assess the effect of tranexamic acid (TXA) on hemorrhagic events and the reoperation rate in patients undergoing LSG. METHODS: The study was designed as a retrospective analysis of patients undergoing LSG. We investigate the patients 6 months before and 6 months after introducing the prophylaxis doses of TXA into our bariatric protocol (non-TXA group vs TXA group). RESULTS: Three hundred fourteen patients underwent LSG in a high-volume center from 2016 to 2017. After introducing TXA, a statistically significant reduction in the incidence of hemorrhage during surgery was observed (22.3% vs 10.8%, p = 0.006). There was a statistically significant reduction in the need for the staple line oversewing (10.2% vs 1.9%, p = 0.002). The mean operating time and the mean length of hospital stay were significantly higher in the non-TXA group than TXA group (63.1 vs 53.7 min, p < 000.1; 2.3 vs 2.1, p = 0.02). In both groups of patients, no venous thromboembolism or other complications occurred within 6 months after the surgery. CONCLUSIONS: The prophylactic doses of TXA may be useful in reducing the hemorrhagic events during LSG. It may also shorten the length of hospital stay and the operating time.