Endoscopic Treatment of Weight Regain Following Roux-en-Y Gastric Bypass: a Systematic Review and Meta-analysis

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dc.contributor Sistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.author BRUNALDI, Vitor Ottoboni FMUSP-HC
MOURA, Diogo Turiani H. de FMUSP-HC
CAMPOS, Josemberg Marins
SANTO, Marco Aurelio FMUSP-HC
MOURA, Eduardo G. H. de FMUSP-HC
dc.date.issued 2018
dc.identifier.citation OBESITY SURGERY, v.28, n.1, p.266-276, 2018
dc.identifier.issn 0960-8923
dc.identifier.uri http://observatorio.fm.usp.br/handle/OPI/24916
dc.description.abstract Roux-en-Y gastric bypass (RYGB) is the most commonly performed bariatric procedure. Despite its high efficacy, some patients regain part of their lost weight. Several endoscopic therapies have been introduced as alternatives to treat weight regain, but most of the articles are relatively small with unclear long-term data. To systematically assess the efficacy of endoscopic therapies for weight regain after RYGB. We searched MEDLINE, EMBASE, Scopus, Web of Science, Cochrane, OVID, CINAHL/EBSCo, LILACS/Bireme, and gray literature. Primary outcomes were absolute weight loss (AWL), excess weight loss (EWL), and total body weight loss (TBWL). Thirty-two studies were included in qualitative analysis. Twenty-six described full-thickness (FT) endoscopic suturing and pooled AWL, EWL, and TBWL at 3 months were 8.5 +/- 2.9 kg, 21.6 +/- 9.3%, and 7.3 +/- 2.6%, respectively. At 6 months, they were 8.6 +/- 3.5 kg, 23.7 +/- 12.3%, and 8.0 +/- 3.9%, respectively. At 12 months, they were 7.63 +/- 4.3 kg, 16.9 +/- 11.1%, and 6.6 +/- 5.0%, respectively. Subgroup analysis showed that all outcomes were significantly higher in the group with FT suturing combined with argon plasma coagulation (APC) (p < 0.0001). Meta-analysis included 15 FT studies and showed greater results. Three studies described superficial-thickness suturing with pooled AWL of 3.0 +/- 3.8, 4.4 +/- 0.07, and 3.7 +/- 7.4 kg at 3, 6, and 12 months, respectively. Two articles described APC alone with mean AWL of 15.4 +/- 2.0 and 15.4 +/- 9.1 kg at 3 and 6 months, respectively. Full-thickness suturing is effective at treating weight regain after RYGB. Performing APC prior to suturing seems to result in greater weight loss. Head-to-head studies are needed to confirm our results. Few studies adequately assess effectiveness of other endoscopic techniques.
dc.language.iso eng
dc.publisher SPRINGER
dc.relation.ispartof Obesity Surgery
dc.rights restrictedAccess
dc.subject Roux-en-Y gastric bypass; Bariatrics; Bariatric surgery; Weight regain; Endoscopy; Endoscopic suturing; Obesity
dc.subject.other transoral outlet reduction; bariatric surgery; suturing device; gastrojejunal revision; life-style; outcomes; pouch; gain; sclerotherapy; recidivism
dc.title Endoscopic Treatment of Weight Regain Following Roux-en-Y Gastric Bypass: a Systematic Review and Meta-analysis
dc.type article
dc.rights.holder Copyright SPRINGER
dc.description.group LIM/35
dc.identifier.doi 10.1007/s11695-017-2986-x
dc.identifier.pmid 29082456
dc.type.category review
dc.type.version publishedVersion
hcfmusp.author BRUNALDI, Vitor Ottoboni:HC:ICHC
hcfmusp.author MOURA, Diogo Turiani H. de:HC:PAHC
hcfmusp.author OKAZAKI, Ossamu:HC:ICHC
hcfmusp.author BERNARDO, Wanderley M.:FM:
hcfmusp.author SANTO, Marco Aurelio:FM:MGT
hcfmusp.author MOURA, Eduardo G. H. de:HC:ICHC
hcfmusp.author.external · JIRAPINYO, Pichamol:Harvard Med Sch, Brigham & Womens Hosp, Boston, MA USA
· GALVO NETO, Manoel:Gastro Obeso Ctr, Unit Endoscopy, Barata Ribeiro St 237, Sao Paulo, Brazil
· CAMPOS, Josemberg Marins:Fed Univ Pernambuco UFPE, Dept Surg, Recife, PE, Brazil
hcfmusp.origem.id WOS:000418304500041
hcfmusp.origem.id 2-s2.0-85032511970
hcfmusp.publisher.city NEW YORK
hcfmusp.publisher.country USA
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dc.description.index MEDLINE
dc.identifier.eissn 1708-0428
hcfmusp.citation.scopus 12
hcfmusp.citation.wos 11
hcfmusp.affiliation.country Brasil
hcfmusp.affiliation.country Estados Unidos

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