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Long-term follow-up after transoral outlet reduction following Roux-en-Y gastric bypass: Back to stage 0?
Background and study aims Significant weight regain affects up to one-third of patients after Roux-en-Y gastric bypass (RYGB) and demands treatment. Transoral outlet reduction (TORe) with argon plasma coagulation (APC) alone or APC plus full-thickness suturing TORe (APC-FTS) is effective in the sho...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Georg Thieme Verlag KG
2023
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10219785/ https://www.ncbi.nlm.nih.gov/pubmed/37251791 http://dx.doi.org/10.1055/a-2075-1198 |
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author | Brunaldi, Vitor Ottoboni Peixoto de Oliveira, Guilherme Henrique Kerbage, Anthony Ribas, Pedro Henrique Nunes, Felipe Faria, Galileu de Moura, Diogo Riccioppo, Daniel Santo, Marco de Moura, Eduardo |
author_facet | Brunaldi, Vitor Ottoboni Peixoto de Oliveira, Guilherme Henrique Kerbage, Anthony Ribas, Pedro Henrique Nunes, Felipe Faria, Galileu de Moura, Diogo Riccioppo, Daniel Santo, Marco de Moura, Eduardo |
author_sort | Brunaldi, Vitor Ottoboni |
collection | PubMed |
description | Background and study aims Significant weight regain affects up to one-third of patients after Roux-en-Y gastric bypass (RYGB) and demands treatment. Transoral outlet reduction (TORe) with argon plasma coagulation (APC) alone or APC plus full-thickness suturing TORe (APC-FTS) is effective in the short term. However, no study has investigated the course of gastrojejunostomy (GJ) or quality of life (QOL) data after the first post-procedure year. Patients and methods Patients eligible for a 36-month follow-up visit after TORe underwent upper gastrointestinal endoscopy with measurement of the GJ and answered QOL questionnaires (RAND-36). The primary aim was to evaluate the long-term outcomes of TORe, including weight loss, QOL, and GJ anastomosis (GJA) size. Comparisons between APC and APC-FTS TORe were a secondary aim. Results Among 39 eligible patients, 29 returned for the 3-year follow-up visit. There were no significant differences in demographics between APC and APC-FTS TORe groups. At 3 years, patients from both groups regained all the weight lost at 12 months, and the GJ diameter was similar to the pre-procedure assessment. As to QOL, most improvements seen at 12 months were lost at 3 years, returning to pre-procedure levels. Only the energy/fatigue domain improvement was kept between the 1- and 3-year visits. Conclusions Obesity is a chronic relapsing disease. Most effects of TORe are lost at 3 years, and redilation of the GJA occurs. Therefore, TORe should be considered iterative rather than a one-off procedure. |
format | Online Article Text |
id | pubmed-10219785 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Georg Thieme Verlag KG |
record_format | MEDLINE/PubMed |
spelling | pubmed-102197852023-05-27 Long-term follow-up after transoral outlet reduction following Roux-en-Y gastric bypass: Back to stage 0? Brunaldi, Vitor Ottoboni Peixoto de Oliveira, Guilherme Henrique Kerbage, Anthony Ribas, Pedro Henrique Nunes, Felipe Faria, Galileu de Moura, Diogo Riccioppo, Daniel Santo, Marco de Moura, Eduardo Endosc Int Open Background and study aims Significant weight regain affects up to one-third of patients after Roux-en-Y gastric bypass (RYGB) and demands treatment. Transoral outlet reduction (TORe) with argon plasma coagulation (APC) alone or APC plus full-thickness suturing TORe (APC-FTS) is effective in the short term. However, no study has investigated the course of gastrojejunostomy (GJ) or quality of life (QOL) data after the first post-procedure year. Patients and methods Patients eligible for a 36-month follow-up visit after TORe underwent upper gastrointestinal endoscopy with measurement of the GJ and answered QOL questionnaires (RAND-36). The primary aim was to evaluate the long-term outcomes of TORe, including weight loss, QOL, and GJ anastomosis (GJA) size. Comparisons between APC and APC-FTS TORe were a secondary aim. Results Among 39 eligible patients, 29 returned for the 3-year follow-up visit. There were no significant differences in demographics between APC and APC-FTS TORe groups. At 3 years, patients from both groups regained all the weight lost at 12 months, and the GJ diameter was similar to the pre-procedure assessment. As to QOL, most improvements seen at 12 months were lost at 3 years, returning to pre-procedure levels. Only the energy/fatigue domain improvement was kept between the 1- and 3-year visits. Conclusions Obesity is a chronic relapsing disease. Most effects of TORe are lost at 3 years, and redilation of the GJA occurs. Therefore, TORe should be considered iterative rather than a one-off procedure. Georg Thieme Verlag KG 2023-05-26 /pmc/articles/PMC10219785/ /pubmed/37251791 http://dx.doi.org/10.1055/a-2075-1198 Text en The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/) https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License, which permits unrestricted reproduction and distribution, for non-commercial purposes only; and use and reproduction, but not distribution, of adapted material for non-commercial purposes only, provided the original work is properly cited. |
spellingShingle | Brunaldi, Vitor Ottoboni Peixoto de Oliveira, Guilherme Henrique Kerbage, Anthony Ribas, Pedro Henrique Nunes, Felipe Faria, Galileu de Moura, Diogo Riccioppo, Daniel Santo, Marco de Moura, Eduardo Long-term follow-up after transoral outlet reduction following Roux-en-Y gastric bypass: Back to stage 0? |
title | Long-term follow-up after transoral outlet reduction following Roux-en-Y gastric bypass: Back to stage 0? |
title_full | Long-term follow-up after transoral outlet reduction following Roux-en-Y gastric bypass: Back to stage 0? |
title_fullStr | Long-term follow-up after transoral outlet reduction following Roux-en-Y gastric bypass: Back to stage 0? |
title_full_unstemmed | Long-term follow-up after transoral outlet reduction following Roux-en-Y gastric bypass: Back to stage 0? |
title_short | Long-term follow-up after transoral outlet reduction following Roux-en-Y gastric bypass: Back to stage 0? |
title_sort | long-term follow-up after transoral outlet reduction following roux-en-y gastric bypass: back to stage 0? |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10219785/ https://www.ncbi.nlm.nih.gov/pubmed/37251791 http://dx.doi.org/10.1055/a-2075-1198 |
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