Skip to main content
Erschienen in: Obesity Surgery 3/2017

30.09.2016 | Original Contributions

Prospective Comparison and Quality of Life for Single-Incision and Conventional Laparoscopic Sleeve Gastrectomy in a Series of Morbidly Obese Patients

verfasst von: Andrea Porta, Alberto Aiolfi, Cinzia Musolino, Ilaria Antonini, Marco Antonio Zappa

Erschienen in: Obesity Surgery | Ausgabe 3/2017

Einloggen, um Zugang zu erhalten

Abstract

Background

Laparoscopic sleeve gastrectomy has gained a wide acceptance in the surgical community with an increasing popularity in the field of bariatric surgery. Simultaneously more surgeons have become acquainted with the single port techniques and sleeve gastrectomy has been regarded as an ideal field of application. Literature is scarce about operative and clinical outcomes of single port sleeve gastrectomy compared to conventional laparoscopy. The primary purpose of the study was to compare operative outcomes in the two study groups. Assessment and comparison of functional outcomes in terms of quality of life between groups was also performed.

Methods

Prospective data on 130 consecutive patients who underwent randomized SI or CL sleeve gastrectomy were collected between January 2009 to December 2014. Preoperative parameters, outcomes, post-operative functional results and quality of life, according to the short-form SF-36 questionnaire, were evaluated and compared between groups.

Results

65 patients underwent conventional laparoscopic (CL) and 65 single incision (SI) sleeve gastrectomy. Operative time, post-operative pain, in-hospital stay, and complications were similar in the two groups. No difference emerged with respect to passage of flatus and resumption of oral intake (p = NS). Cosmetic results were excellent in SI patients with higher satisfaction rates. Post-operative quality of life was significant higher compared to baseline (p < 0.05), and comparable between the two procedures.

Conclusions

Single incision sleeve gastrectomy is safe, effective and comparable to the conventional laparoscopic technique in terms of outcomes. Post-operative quality of life is comparable between the two procedures.
Literatur
1.
Zurück zum Zitat Cottam D, Qureshi FD, Mattar SG, et al. Laparoscopic sleeve gastrectomy as an initial weight-loss procedure for high-risk patients with morbid obesity. Surg Endosc. 2006;20:859–63.CrossRefPubMed Cottam D, Qureshi FD, Mattar SG, et al. Laparoscopic sleeve gastrectomy as an initial weight-loss procedure for high-risk patients with morbid obesity. Surg Endosc. 2006;20:859–63.CrossRefPubMed
2.
Zurück zum Zitat Regan JP, Inabnet WB, Gagner M, et al. Early experience with two-stage laparoscopic roux-en-Y gastric bypass as an alternative in the super-super obese patient. Obes Surg. 2003;13:861–4.CrossRefPubMed Regan JP, Inabnet WB, Gagner M, et al. Early experience with two-stage laparoscopic roux-en-Y gastric bypass as an alternative in the super-super obese patient. Obes Surg. 2003;13:861–4.CrossRefPubMed
3.
Zurück zum Zitat Sammour T, Hill AG, Singh P, Ranasinghe A, Babor R, Rahman H. Laparoscopic sleeve gastrectomy as a single-stage bariatric procedure. Obes Surg. 2010;20:271–5.CrossRefPubMed Sammour T, Hill AG, Singh P, Ranasinghe A, Babor R, Rahman H. Laparoscopic sleeve gastrectomy as a single-stage bariatric procedure. Obes Surg. 2010;20:271–5.CrossRefPubMed
4.
Zurück zum Zitat Boza C, Salinas J, Salgado N, Pérez G, Raddatz A, Funke R, Pimentel F, Ibáñez L. Laparoscopic sleeve gastrectomy as a stand-alone procedure for morbid obesity: report of 1,000 cases and 3-year follow-up. Obes Surg. 2012;22:866–71.CrossRefPubMed Boza C, Salinas J, Salgado N, Pérez G, Raddatz A, Funke R, Pimentel F, Ibáñez L. Laparoscopic sleeve gastrectomy as a stand-alone procedure for morbid obesity: report of 1,000 cases and 3-year follow-up. Obes Surg. 2012;22:866–71.CrossRefPubMed
5.
Zurück zum Zitat Lakdawala MA, Bhasker A, Mulchandani D, et al. Comparison between the results of laparoscopic sleeve gastrectomy and laparoscopic roux-en-Y gastric bypass in the Indian population: a retrospective 1 year study. Obes Surg. 2010;20:1–6.CrossRefPubMed Lakdawala MA, Bhasker A, Mulchandani D, et al. Comparison between the results of laparoscopic sleeve gastrectomy and laparoscopic roux-en-Y gastric bypass in the Indian population: a retrospective 1 year study. Obes Surg. 2010;20:1–6.CrossRefPubMed
6.
Zurück zum Zitat Vidal P, Ramón JM, Goday A, Benaiges D, Trillo L, Parri A, González S, Pera M, Grande L. Laparoscopic gastric bypass versus laparoscopic sleeve gastrectomy as a definitive surgical procedure for morbid obesity. Mid-Term Results Obes Surg. 2013;23:292–9.CrossRefPubMed Vidal P, Ramón JM, Goday A, Benaiges D, Trillo L, Parri A, González S, Pera M, Grande L. Laparoscopic gastric bypass versus laparoscopic sleeve gastrectomy as a definitive surgical procedure for morbid obesity. Mid-Term Results Obes Surg. 2013;23:292–9.CrossRefPubMed
7.
Zurück zum Zitat Deytel M, Crosby RD, Gagner M. The first international consensus summit for sleeve gastrectomy (SG), New York City, October 25–27, 2007. Obes Surg. 2008;18:487–96.CrossRef Deytel M, Crosby RD, Gagner M. The first international consensus summit for sleeve gastrectomy (SG), New York City, October 25–27, 2007. Obes Surg. 2008;18:487–96.CrossRef
8.
Zurück zum Zitat Hunag CK, Tsai JC, Lo CH, Houng JY, Chen YS, Chi SC, Lee PH. Preliminary surgical results of single-incision transumbilical laparoscopic bariatric surgery. Obes Surg. 2011;21:391–6.CrossRef Hunag CK, Tsai JC, Lo CH, Houng JY, Chen YS, Chi SC, Lee PH. Preliminary surgical results of single-incision transumbilical laparoscopic bariatric surgery. Obes Surg. 2011;21:391–6.CrossRef
10.
Zurück zum Zitat Reavis KM, Hinojosa MV, Smith BR, Nguyen NT. Single-laparoscopic incision transabdominal surgery sleeve gastrectomy. Obes Surg. 2008;18:1492–4.CrossRefPubMed Reavis KM, Hinojosa MV, Smith BR, Nguyen NT. Single-laparoscopic incision transabdominal surgery sleeve gastrectomy. Obes Surg. 2008;18:1492–4.CrossRefPubMed
11.
Zurück zum Zitat Saber AA, Elgamal MH, Itawi EA, et al. Single incision laparoscopic sleeve gastrectomy (SILS): a novel technique. Obes Surg. 2008;18:1338–42.CrossRefPubMed Saber AA, Elgamal MH, Itawi EA, et al. Single incision laparoscopic sleeve gastrectomy (SILS): a novel technique. Obes Surg. 2008;18:1338–42.CrossRefPubMed
12.
Zurück zum Zitat Gentileschi P, Camperchioli I, Benavoli D, Di Lorenzo N, Sica G, Gaspari AL. Laparoscopic single-port sleeve gastrectomy for morbid obesity: preliminary series. Surg Obes Relat Dis. 2010;6:665–9.CrossRefPubMed Gentileschi P, Camperchioli I, Benavoli D, Di Lorenzo N, Sica G, Gaspari AL. Laparoscopic single-port sleeve gastrectomy for morbid obesity: preliminary series. Surg Obes Relat Dis. 2010;6:665–9.CrossRefPubMed
13.
Zurück zum Zitat Farìas C, Fernandez JI, Ovalle C, Cabrera C, De la Maza J, Kosiel K, Molina AM. Transumbilical sleeve gastrectomy with an accessory lateral port: surgical results in 237 patients and 1-year follow-up. Obes Surg. 2013;23:325–31.CrossRefPubMed Farìas C, Fernandez JI, Ovalle C, Cabrera C, De la Maza J, Kosiel K, Molina AM. Transumbilical sleeve gastrectomy with an accessory lateral port: surgical results in 237 patients and 1-year follow-up. Obes Surg. 2013;23:325–31.CrossRefPubMed
14.
Zurück zum Zitat Lo C, Latin L, Fariñas Á, Cruz Pico CX, Postoev A, Ibikunle C, Sanni A. Does single-port laparoscopic sleeve gastrectomy result in improved short-term perioperative outcomes compared to conventional multi-port laparoscopic sleeve gastrectomy? Int J Surg. 2015;22:67–71.CrossRefPubMed Lo C, Latin L, Fariñas Á, Cruz Pico CX, Postoev A, Ibikunle C, Sanni A. Does single-port laparoscopic sleeve gastrectomy result in improved short-term perioperative outcomes compared to conventional multi-port laparoscopic sleeve gastrectomy? Int J Surg. 2015;22:67–71.CrossRefPubMed
15.
Zurück zum Zitat Yee J, Koshiver J, Allbon C, Brown C. Comparison of intramuscular ketorolac tromethamine and morphine sulfate for analgesia of pain after major surgery. Pharmacotherapy. 1986;6:253–61.CrossRefPubMed Yee J, Koshiver J, Allbon C, Brown C. Comparison of intramuscular ketorolac tromethamine and morphine sulfate for analgesia of pain after major surgery. Pharmacotherapy. 1986;6:253–61.CrossRefPubMed
16.
Zurück zum Zitat O’Hara D, Fragen R, Kinzer M, Pemberton D. Ketorolac tromethamine as compared with morphine sulfate for treatment of postoperative pain. Clin Pharmacol Ther. 1987;41:556–61.CrossRefPubMed O’Hara D, Fragen R, Kinzer M, Pemberton D. Ketorolac tromethamine as compared with morphine sulfate for treatment of postoperative pain. Clin Pharmacol Ther. 1987;41:556–61.CrossRefPubMed
17.
Zurück zum Zitat Gordon DB, Stevenson KK, Griffie J, Muchka S, Rapp C, Ford-Roberts K. Opioid equianalgesic calculations. J Palliat Med. 1999;2:209–18.CrossRefPubMed Gordon DB, Stevenson KK, Griffie J, Muchka S, Rapp C, Ford-Roberts K. Opioid equianalgesic calculations. J Palliat Med. 1999;2:209–18.CrossRefPubMed
18.
Zurück zum Zitat Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240:205–13.CrossRefPubMedPubMedCentral Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240:205–13.CrossRefPubMedPubMedCentral
19.
Zurück zum Zitat Apolone G, Mosconi P. The Italian SF-36 health survey: translation, validation and norming. J Clin Epidemiol. 1998;51:1025–36.CrossRefPubMed Apolone G, Mosconi P. The Italian SF-36 health survey: translation, validation and norming. J Clin Epidemiol. 1998;51:1025–36.CrossRefPubMed
20.
Zurück zum Zitat Ware JE, Snow KK, Kosinski M. SF36 health survey. Manual and interpretation guide. Boston: New England Medical Centre, The Health Institute; 1993. Ware JE, Snow KK, Kosinski M. SF36 health survey. Manual and interpretation guide. Boston: New England Medical Centre, The Health Institute; 1993.
21.
Zurück zum Zitat Nguyen NT, Goldman C, Rosenquist CJ, et al. Laparoscopic versus open gastric bypass: a randomized study of outcomes, quality of life, and costs. Ann Surg. 2001;234:279–89.CrossRefPubMedPubMedCentral Nguyen NT, Goldman C, Rosenquist CJ, et al. Laparoscopic versus open gastric bypass: a randomized study of outcomes, quality of life, and costs. Ann Surg. 2001;234:279–89.CrossRefPubMedPubMedCentral
22.
Zurück zum Zitat Weller W, Rosati C. Comparing outcomes of laparoscopic versus open bariatric surgery. Ann Surg. 2008;248:10–5.CrossRefPubMed Weller W, Rosati C. Comparing outcomes of laparoscopic versus open bariatric surgery. Ann Surg. 2008;248:10–5.CrossRefPubMed
23.
Zurück zum Zitat Saber AA, El-Ghazaly TH, Dewoolkar AV, Slayton SA. Single-incision laparoscopic sleeve gastrectomy versus conventional multiport laparoscopic sleeve gastrectomy: technical considerations and strategic modifications. Surg Obes Relat Dis. 2010;658–664. Saber AA, El-Ghazaly TH, Dewoolkar AV, Slayton SA. Single-incision laparoscopic sleeve gastrectomy versus conventional multiport laparoscopic sleeve gastrectomy: technical considerations and strategic modifications. Surg Obes Relat Dis. 2010;658–664.
24.
Zurück zum Zitat Gomberawalla A, Salamat A, Lutfi R. Outcome analysis of single incision vs traditional multiport sleeve gastrectomy: a matched cohort study. Obes Surg. 2014;24:1870–4.CrossRefPubMed Gomberawalla A, Salamat A, Lutfi R. Outcome analysis of single incision vs traditional multiport sleeve gastrectomy: a matched cohort study. Obes Surg. 2014;24:1870–4.CrossRefPubMed
25.
Zurück zum Zitat Delgado S, Ibarzabal A, Adelsdorfer C, Adelsdorfer W, Corcelles R, Momblan D, Lacy AM. Transumbilical single-port sleeve gastrectomy: initial experience and comparative study. Surg Endosc. 2012;26:1247–53.CrossRefPubMed Delgado S, Ibarzabal A, Adelsdorfer C, Adelsdorfer W, Corcelles R, Momblan D, Lacy AM. Transumbilical single-port sleeve gastrectomy: initial experience and comparative study. Surg Endosc. 2012;26:1247–53.CrossRefPubMed
26.
Zurück zum Zitat Lakdawala M, Agarwal A, Dhar S, Dhulla N, Remedios C, Bhasker AG. Single-incision sleeve gastrectomy versus laparoscopic sleeve gastrectomy. A 2-year comparative analysis of 600 patients. Obes Surg. 2015;25:607–14.CrossRefPubMed Lakdawala M, Agarwal A, Dhar S, Dhulla N, Remedios C, Bhasker AG. Single-incision sleeve gastrectomy versus laparoscopic sleeve gastrectomy. A 2-year comparative analysis of 600 patients. Obes Surg. 2015;25:607–14.CrossRefPubMed
27.
Zurück zum Zitat Sucher R, Resch T, Mohr E, Perathoner A, Biebl M, Pratschke J, Mittermair R. Single-incision laparoscopic sleeve gastrectomy versus multiport laparoscopic sleeve gastrectomy: analysis of 80 cases in a single center. J Laparoendosc Adv Surg Tech A. 2014;24:83–8.CrossRefPubMed Sucher R, Resch T, Mohr E, Perathoner A, Biebl M, Pratschke J, Mittermair R. Single-incision laparoscopic sleeve gastrectomy versus multiport laparoscopic sleeve gastrectomy: analysis of 80 cases in a single center. J Laparoendosc Adv Surg Tech A. 2014;24:83–8.CrossRefPubMed
28.
Zurück zum Zitat Sajid MS, Ladwa N, Kalra L, Hutson KK, Singh KK, Sayegh M. Single-incision laparoscopic cholecystectomy versus conventional laparoscopic cholecystectomy: meta-analysis and systematic review of randomized controlled trials. World J Surg. 2012;36:2644–53.CrossRefPubMed Sajid MS, Ladwa N, Kalra L, Hutson KK, Singh KK, Sayegh M. Single-incision laparoscopic cholecystectomy versus conventional laparoscopic cholecystectomy: meta-analysis and systematic review of randomized controlled trials. World J Surg. 2012;36:2644–53.CrossRefPubMed
29.
Zurück zum Zitat St Peter SD, Adibe OO, Juang D, Sharp SW, Garey CL, Laituri CA, et al. Single incision versus standard 3-port laparoscopic appendectomy: a prospective randomized trial. Ann Surg. 2011;254:586–90.CrossRefPubMed St Peter SD, Adibe OO, Juang D, Sharp SW, Garey CL, Laituri CA, et al. Single incision versus standard 3-port laparoscopic appendectomy: a prospective randomized trial. Ann Surg. 2011;254:586–90.CrossRefPubMed
30.
Zurück zum Zitat Choi ST, Lee JN, Kim KK, Park YH, Lee WK, Baek JH, Lee TH. Single-port laparoscopic appendectomy versus conventional laparoscopic appendectomy: a prospective randomized controlled study. Ann Surg. 2013;257:214–8.CrossRefPubMed Choi ST, Lee JN, Kim KK, Park YH, Lee WK, Baek JH, Lee TH. Single-port laparoscopic appendectomy versus conventional laparoscopic appendectomy: a prospective randomized controlled study. Ann Surg. 2013;257:214–8.CrossRefPubMed
Metadaten
Titel
Prospective Comparison and Quality of Life for Single-Incision and Conventional Laparoscopic Sleeve Gastrectomy in a Series of Morbidly Obese Patients
verfasst von
Andrea Porta
Alberto Aiolfi
Cinzia Musolino
Ilaria Antonini
Marco Antonio Zappa
Publikationsdatum
30.09.2016
Verlag
Springer US
Erschienen in
Obesity Surgery / Ausgabe 3/2017
Print ISSN: 0960-8923
Elektronische ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-016-2338-2

Weitere Artikel der Ausgabe 3/2017

Obesity Surgery 3/2017 Zur Ausgabe

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare
CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare
CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare
CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.