Endoscopic Vacuum Therapy for Staple Line Leaks after Sleeve Gastrectomy.

PURPOSE: Management of staple line leaks (SLL) after sleeve gastrectomy (SG) is challenging. The aim of this study was to evaluate the effectiveness of a novel endoscopic vacuum therapy (EVT) modality in the management of sleeve leaks. MATERIALS AND METHODS: Eight patients were treated with EVT for SLL. Therapy data and outcome measures including duration of therapy, therapy success, and change of treatment strategy were collected and analyzed. RESULTS: During the study period, SLL occurred in 1.6% of patients who underwent SG. After 9.8 ± 8.6 days of EVT, 3.3 ± 2.2 endoscopies, and 19 ± 15.1 days of hospitalization, endoscopic treatment using EVT was successful in seven out of eight patients (87.5%). CONCLUSIONS: EVT is an effective method for the management of staple line leaks after sleeve gastrectomy. The use of the intraluminal open-pore film drainage (OFD) could be considered as an advantageous modality of EVT, regarding placement and complications.

Patients with Schizophrenia Do Not Demonstrate Worse Outcome After Sleeve Gastrectomy: a Short-Term Cohort Study.

PURPOSE: The aim of this study was to compare surgical and psychiatric outcome and weight loss in schizophrenia patients with mentally healthy patients after sleeve gastrectomy. MATERIALS AND METHODS: A cohort study design was selected, comprising patients with schizophrenia with mentally healthy patients who underwent sleeve gastrectomy and were adherent to a follow-up at least 12 months after surgery. RESULTS: Seven schizophrenia (5 male, 2 female) and 59 (12 male, 47 female) mentally healthy patients were included in this study. A laparoscopic sleeve gastrectomy was performed safely in all 66 patients. The calculated excess weight loss (%EWL) showed no significant differences in both groups and reached 51.68 ± 15.84% for schizophrenia group and 60.68 ± 19.95% for mentally healthy group at 24-month follow-up (p = 0.33). The decrease in the HbA1c levels within 2 years after sleeve gastrectomy was similar in both groups (p = 0.79, 0.88, 0.82, 0.73 for surgery time, time of 6-, 12-, and 24-month follow-up respectively). The psychiatric status of the patients of the schizophrenia group was stable in all cases and no exacerbation of psychiatric symptoms was observed during time of follow-up. Furthermore, an overall significant improvement of the self-estimated mood and satisfaction was observed in both groups (Manova: f = 1.26, p < 0.0001). CONCLUSIONS: The results 2 years after sleeve gastrectomy in stable patients with schizophrenia and after an adequate psychological evaluation were encouraging and comparable to the outcome in mentally healthy patients.