Prospective evaluation of transoral outlet reduction (TORe) after Roux-en-Y gastric bypass (RYGB) failure.
Bariatric endoscopy
Gastric bypass failure
Overstitch
TORe
Journal
Surgical endoscopy
ISSN: 1432-2218
Titre abrégé: Surg Endosc
Pays: Germany
ID NLM: 8806653
Informations de publication
Date de publication:
12 Jan 2024
12 Jan 2024
Historique:
received:
23
06
2023
accepted:
17
12
2023
medline:
13
1
2024
pubmed:
13
1
2024
entrez:
12
1
2024
Statut:
aheadofprint
Résumé
Weight regain after RYGB is multifactorial including dilatation of the gastro-jejunal anastomosis. Transoral outlet reduction (TORe) procedure is a minimally invasive alternative to surgical anastomotic revision. We conducted a prospective, multicenter, simple blind, randomized study in patients with weight regain following RYGB, comparing the efficacy of conventional nutritional and behavioral management associated with a TORe procedure (TORe group) with conventional management alone and a Sham procedure (Sham group). The main objective of this study was to evaluate the percentage of excess weight loss (%EWL) at 12 months after endoscopy. From January 2015 to January 2019, 73 subjects were randomized in four French Bariatric centers. The final analysis involved 50 subjects, 25 in each group, 44 women, 6 men, with an average BMI of 40.6 kg/m After RYGBP failure linked to the dilatation of the gastro-jejunal anastomosis, TORe procedure with nutritional management results in significantly higher %EWL at 12 months compared to patients with nutritional management alone. As surgery, this minimally invasive endoscopic procedure can be associated with severe adverse events.
Sections du résumé
BACKGROUND AND AIMS
OBJECTIVE
Weight regain after RYGB is multifactorial including dilatation of the gastro-jejunal anastomosis. Transoral outlet reduction (TORe) procedure is a minimally invasive alternative to surgical anastomotic revision.
METHODS
METHODS
We conducted a prospective, multicenter, simple blind, randomized study in patients with weight regain following RYGB, comparing the efficacy of conventional nutritional and behavioral management associated with a TORe procedure (TORe group) with conventional management alone and a Sham procedure (Sham group). The main objective of this study was to evaluate the percentage of excess weight loss (%EWL) at 12 months after endoscopy.
RESULTS
RESULTS
From January 2015 to January 2019, 73 subjects were randomized in four French Bariatric centers. The final analysis involved 50 subjects, 25 in each group, 44 women, 6 men, with an average BMI of 40.6 kg/m
CONCLUSIONS
CONCLUSIONS
After RYGBP failure linked to the dilatation of the gastro-jejunal anastomosis, TORe procedure with nutritional management results in significantly higher %EWL at 12 months compared to patients with nutritional management alone. As surgery, this minimally invasive endoscopic procedure can be associated with severe adverse events.
Identifiants
pubmed: 38216748
doi: 10.1007/s00464-023-10650-5
pii: 10.1007/s00464-023-10650-5
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
Références
Sjöström L, Narbro K, Sjöström CD, Karason K, Larsson B, Wedel H et al (2007) Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med 357(8):741–752
doi: 10.1056/NEJMoa066254
pubmed: 17715408
Sjöström L, Lindroos AK, Peltonen M, Torgerson J, Bouchard C, Carlsson B et al (2004) Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med 351(26):2683–2693
doi: 10.1056/NEJMoa035622
pubmed: 15616203
Karlsson J, Sjöström L, Sullivan M (1998) Swedish obese subjects (SOS)—an intervention study of obesity. Two-year follow-up of health-related quality of life (HRQL) and eating behavior after gastric surgery for severe obesity. Int J Obes Relat Metab Disord 22(2):113–126
doi: 10.1038/sj.ijo.0800553
pubmed: 9504319
Obeid NR, Malick W, Concors SJ, Fielding GA, Kurian MS, Ren-Fielding CJ (2016) Long-term outcomes after Roux-en-Y gastric bypass: 10- to 13-year data. Surg Obes Relat Dis 12(1):11–20
doi: 10.1016/j.soard.2015.04.011
pubmed: 26410537
Magro DO, Ueno M, de Coelho-Neto JS, Callejas-Neto F, Pareja JC, Cazzo E (2018) Long-term weight loss outcomes after banded Roux-en-Y gastric bypass: a prospective 10-year follow-up study. Surg Obes Relat Dis 14(7):910–917
doi: 10.1016/j.soard.2018.03.023
pubmed: 29706496
Adams TD, Davidson LE, Hunt SC (2018) Weight and metabolic outcomes 12 years after gastric bypass. N Engl J Med 378(1):93–96
doi: 10.1056/NEJMc1714001
pubmed: 29298157
Abu Dayyeh BK, Lautz DB, Thompson CC (2011) Gastrojejunal stoma diameter predicts weight regain after Roux-en-Y gastric bypass. Clin Gastroenterol Hepatol 9(3):228–233
doi: 10.1016/j.cgh.2010.11.004
pubmed: 21092760
León F, Maiz C, Daroch D, Quezada N, Gabrielli M, Muñoz C et al (2015) Laparoscopic hand-sewn revisional gastrojejunal plication for weight loss failure after Roux-en-Y gastric bypass. Obes Surg 25(4):744–749
doi: 10.1007/s11695-014-1463-z
pubmed: 25618780
Thompson CC, Slattery J, Bundga ME, Lautz DB (2006) Peroral endoscopic reduction of dilated gastrojejunal anastomosis after Roux-en-Y gastric bypass: a possible new option for patients with weight regain. Surg Endosc 20(11):1744–1748
doi: 10.1007/s00464-006-0045-0
pubmed: 17024527
Dhindsa BS, Saghir SM, Naga Y, Dhaliwal A, Ramai D, Cross C et al (2020) Efficacy of transoral outlet reduction in Roux-en-Y gastric bypass patients to promote weight loss: a systematic review and meta-analysis. Endosc Int Open 8(10):E1332–E1340
doi: 10.1055/a-1214-5822
pubmed: 33015335
pmcid: 7511267
Thompson CC, Chand B, Chen YK, DeMarco DC, Miller L, Schweitzer M et al (2013) Endoscopic suturing for transoral outlet reduction increases weight loss after Roux-en-Y gastric bypass surgery. Gastroenterology 145(1):129-137.e3
doi: 10.1053/j.gastro.2013.04.002
pubmed: 23567348
Jirapinyo P, Kumar N, AlSamman MA, Thompson CC (2020) Five-year outcomes of transoral outlet reduction for the treatment of weight regain after Roux-en-Y gastric bypass. Gastrointest Endosc 91(5):1067–1073
doi: 10.1016/j.gie.2019.11.044
pubmed: 31816315
Laffin AE, Kendale SM, Huncke TK (2020) Severity and duration of hypoxemia during outpatient endoscopy in obese patients: a retrospective cohort study. Can J Anaesth 67(9):1182–1189
doi: 10.1007/s12630-020-01737-x
pubmed: 32514693
Vargas EJ, Bazerbachi F, Rizk M, Rustagi T, Acosta A, Wilson EB et al (2018) Transoral outlet reduction with full thickness endoscopic suturing for weight regain after gastric bypass: a large multicenter international experience and meta-analysis. Surg Endosc 32(1):252–259
doi: 10.1007/s00464-017-5671-1
pubmed: 28664438
Espinet Coll E, Nebreda Durán J, López-Nava Breviere G, Galvao Neto M, Gómez Valero JA, Bacchiddu S et al (2018) Efficacy and safety of transoral outlet reduction via endoscopic suturing in patients with weight regain after a surgical Roux-en-Y gastric bypass. Rev Esp Enferm Dig 110(9):551–556
pubmed: 29739229
Reinhold RB (1982) Critical analysis of long term weight loss following gastric bypass. Surg Gynecol Obstet 155(3):385–394
pubmed: 7051382
EuroQoL Group (1990) EuroQoL—a new facility for the measurement of health-related quality of life. Health Policy 16:199–208
doi: 10.1016/0168-8510(90)90421-9
Kolotkin RL, Crosby RD, Kosloski KD, Williams GR (2001) Development of a brief measure to assess quality of life in obesity. Obes Res 9:102–111
doi: 10.1038/oby.2001.13
pubmed: 11316344
Picot J, Jones J, Colquitt JL, Gospodarevskaya E, Loveman E, Baxter L et al (2009) The clinical effectiveness and cost-effectiveness of bariatric (weight loss) surgery for obesity: a systematic review and economic evaluation. Health Technol Assess 13(41):1–190, 215–357, iii–iv
Schulman AR, Kumar N, Thompson CC (2018) Transoral outlet reduction: a comparison of purse-string with interrupted stitch technique. Gastrointest Endosc 87(5):1222–1228
doi: 10.1016/j.gie.2017.10.034
pubmed: 29108984
de Moura DTH, Jirapinyo P, Thompson CC (2019) Modified-ESD plus APC and suturing for treatment of weight regain after gastric bypass. Obes Surg 29(6):2001–2002
doi: 10.1007/s11695-019-03808-5
pubmed: 30937873