IMPACT OF STAPLER FIRINGS IN GASTRIC POUCH CREATION ON SHORT-AND LONG-TERM OUTCOMES OF MINI-GASTRIC BYPASS: A NATIONAL BARIATRIC REGISTRY ANALYSIS ruslan.menzulin@gmail.com

 

IMPACT OF STAPLER FIRINGS IN GASTRIC POUCH CREATION ON SHORT-AND LONG-TERM OUTCOMES OF MINI-GASTRIC BYPASS: A NATIONAL BARIATRIC REGISTRY ANALYSIS

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Russia

Oral or Poster

Creating a gastric pouch during mini-gastric bypass/one anastomosis gastric bypass (MGB-OAGB) requires multiple stapler firings (SF). We assessed whether SF count impacts perioperative and long-term outcomes of MGB-OAGB.

A multicenter retrospective cohort study was performed using data from the Russian National Bariatric Registry (2013-2024). Adult patients with morbid obesity, treated with primary MGB-OAGB, were categorized as SF≤4 and SF>4. Analyses included descriptive statistics and multivariate logistic regression.

Overall, 2,895 patients with SF≤4 and 7,827 with SF>4 were included (Table 1). SF≤4 patients had lower rates of BMI≥40 kg/m² (67.2% vs. 72.8%, p<0.001), hypertension (41.0% vs. 52.6%, p<0.001), and sleep apnea (13.6% vs. 19.6%, p<0.001), but higher rates of thromboembolic risk factors (23.1% vs. 9.5%, p<0.001). Despite more procedures, performed simultaneously with MGB-OAGB (21.8% vs. 14.5%, p<0.001), SF≤4 patients had a shorter median operative time (90 [IQR: 70-110) vs. 100 [IQR: 85-120] minutes, p<0.001), fewer anastomotic/stapler-line bleedings (0.4% vs. 1.2%, p<0.001), lower surgical (1.4% vs. 2.4%, p=0.002) and overall in-hospital morbidity (1.6% vs. 2.7%, p<0.001) (Table 1). Multivariate logistic regression analysis showed that using SF>4 was associated with higher odds of surgical complications (OR 1.49; 95%CI:1.04-2.14), yet did not affect the likelihood of achieving >50% excess weight loss at 6 months (OR 0.88; 95%CI:0.70-1.12) or 12 months (OR 1.09; 95%CI:0.84-1.40) post-MGB-OAGB (Table 2).

When feasible, SF count for creating a gastric pouch should be minimized, as SF≤4 can reduce operative time, surgical complications, and overall morbidity. Withal, SF count does not impact 1-year weight loss.