Prospective randomized controlled trial of the closure of gastrojejunal anastomosis in RYGB with absorbable and inabsorbable thread

Abstract

Introduction: The Roux-en-Y gastric bypass (RYGB) is, currently, the most performed technique in Brazil. Suture threads are classified according to their degradation properties. Objective: To analyze the influence on the size of the gastrojejunal anastomosis performed in Roux-en-Y gastric bypass surgery, as well as the main complications with the use of absorbable or inabsorbable thread. Methods: This study followed a prospective and randomized clinical trial, initially with 40 participants, with only 37 participants being duly selected, 19 of whom underwent gastrojejunostomy closure with an absorbable (Abs) polydioxanone suture (PDS II®) and 18 with the inabsorbable (Inb) ETHIBOND®. Statistical analysis was performed using the ANOVA and logistic regression tools (p<0.05 significant). Results: General complications and Upper Digestive Endoscopy (UDE) were less frequent at the end of 12 months in both groups. At the end of twelve months, the number of complications of the Inb thread decreased considerably, while the number of complications of the Abs thread showed an increase in other complications, including marginal ulcer and intrusive thread. Despite this, there was no significant difference between groups in terms of total weight loss. There was no statistically significant difference between the final values of the anastomotic diameter. The percentage of weight loss over the 12 months was 33.77 ± 6.97% for the Inb group and 36.10 ± 4.89% for the Abs group (p<0.05). Conclusion: Both suture threads (Inb and Abs) presented similar complications and did not present significant differences between the values of weight, gastrojejunal anastomosis, and pouch.