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Closure of mesenteric defects during Roux-en-Y gastric bypass for obesity: A systematic review and meta-analysis protocol
Abertawe Bro Morgannwg Univ Hlth Board, Wales.
Gothenburg Univ, Sweden.
Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Surgery in Linköping.
Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Surgery in Linköping. Abertawe Bro Morgannwg Univ Hlth Board, Wales; Welsh Inst Metab and Bariatr Surg, Wales.
2019 (English)In: INTERNATIONAL JOURNAL OF SURGERY PROTOCOLS, ISSN 2468-3574, Vol. 15Article, review/survey (Refereed) Published
Abstract [en]

Introduction: Closure of mesenteric defects during laparoscopic Roux-en-Y gastric bypass surgery (RYGB) has not been fully established as standard operative practice. However, in recent years a body of evidence has emerged suggesting that non-closure of defects leads to increased rates of internal herniation and its potential consequences, including the need for reoperation, along with an associated morbidity and mortality risk. Within the emerging literature there has also been some evidence of a greater risk of 30-day complications in closure groups. This systematic review and meta-analysis aims to look at the existing evidence and provide guidance on whether closure of mesenteric defects should be standard operative practice. Methods: The systematic review and meta-analysis has been registered a priori. A literature search will be performed interrogating the Medline and Embase databases via Ovid, and also the Cochrane Controlled Register of Trials (CENTRAL), to identify randomised and non-randomised studies reporting comparative outcomes following closure vs. non-closure of mesenteric defects during RYGB. The primary outcome will be reoperation for small bowel obstruction, and secondary outcomes will include internal herniation, jejuno-jejunal anastomosis narrowing or kinking, adhesions, complications (amp;lt;30 days and amp;gt;30 days after surgery), 30-day mortality, reoperation, and any other outcome deemed relevant and reported in more than one study. (C) 2019 Published by Elsevier Ltd on behalf of Surgical Associates Ltd.

Place, publisher, year, edition, pages
ELSEVIER SCI LTD , 2019. Vol. 15
Keywords [en]
Meta-analysis; Mesenteric defect; Obesity surgery; Laparoscopic Roux-en-Y gastric bypass surgery; Internal herniation; Small bowel obstruction
National Category
Surgery
Identifiers
URN: urn:nbn:se:liu:diva-159018DOI: 10.1016/j.isjp.2019.02.003ISI: 000471855600001OAI: oai:DiVA.org:liu-159018DiVA, id: diva2:1338077
Available from: 2019-07-19 Created: 2019-07-19 Last updated: 2019-07-19

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Barry, Jonathan D.
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